{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T10:30:21Z","timestamp":1791541821608,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T00:00:00Z","timestamp":1692230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Routine hemodialysis depends on well\u2010functioning vascular access. In the event of vascular access dysfunction, percutaneous transluminal balloon angioplasty (PTA) is conducted to restore patency. Although an angioplasty procedure can provide an excellent immediate result by opening the access to allow dialysis to continue, the long\u2010term patency rates are less than satisfactory. The goal of this study was to assess the outcomes of patients who underwent a novel vessel preparation via longitudinal, controlled\u2010depth micro\u2010incisions prior to PTA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter, prospective, observational registry enrolled hemodialysis patients scheduled to undergo PTA of their arteriovenous fistula or graft due to clinical or hemodynamic abnormalities. A primary endpoint was anatomic success, defined as angiographic confirmation of &lt;30% residual stenosis post\u2010procedure without an adverse event. Additional assessments included device technical success, clinical success, freedom from target lesion revascularization, target lesion primary patency, and circuit primary patency at 6\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      A total of 148 lesions were treated with the FLEX Vessel Prep\u2122 System (FLEX VP) prior to PTA in 114 subjects at eight clinical sites. Target lesions were 21\u2009\u00b1\u200925\u2009mm in length with mean pre\u2010procedure stenosis of 75.2%\u2009\u00b1\u20094.7%. Five procedural complications were recorded without serious adverse events. Two subjects did not complete the follow\u2010up evaluation. Target lesion primary patency across all subjects at 6\u2010months was 62.2% with mean freedom from target lesion revascularization of 202.7\u2009days. Target lesion primary patency and freedom from target lesion revascularization for AVF cases (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200972) were 67.5% and 212.9\u2009days, respectively. Target lesion primary patency and freedom from target lesion revascularization for AVGs (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200942) were 52.4% and 183.3\u2009days, respectively. In cases treating AVF cephalic arch stenosis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925), 6\u2010month target lesion primary patency was 70.6% and freedom from target lesion revascularization was 213.4\u2009days.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This FLEX\u2010AV registry demonstrates safety and effectiveness, notably in the cephalic arch and AVGs, when FLEX VP is used prior to PTA for treatment of vascular access dysfunction in a population of end\u2010stage renal disease subjects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hdi.13111","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T12:12:07Z","timestamp":1692619927000},"page":"378-387","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Longitudinal micro\u2010incision creation prior to balloon angioplasty for treatment of arteriovenous access dysfunction in a real\u2010world patient population: 6\u2010month cohort analysis"],"prefix":"10.1111","volume":"27","author":[{"given":"John","family":"Aruny","sequence":"first","affiliation":[{"name":"The Dialysis Access Institute, Medical University of South Carolina  Orangeburg South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey E.","family":"Hull","sequence":"additional","affiliation":[{"name":"Richmond Vascular Center  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Yevzlin","sequence":"additional","affiliation":[{"name":"University of Michigan Nephrology  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro C.","family":"Alvarez","sequence":"additional","affiliation":[{"name":"SSM Health  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason D.","family":"Beaver","sequence":"additional","affiliation":[{"name":"Flowers Hospital  Dothan Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Robert W.","family":"Heidepriem","sequence":"additional","affiliation":[{"name":"Birmingham Vascular Surgeons  Vestavia Hills Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Serle","sequence":"additional","affiliation":[{"name":"Pinehurst Nephrology Associates  Pinehurst North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,17]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"2021 USRDS Annual Data Report: epidemiology of kidney disease in the United States","author":"United States Renal Data System","year":"2021"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.195.1.7892454"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.15.14650"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.09.056"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2016.08.025"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0231463"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2432051232"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/15.12.2029"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.RVI.0000136029.88286.48"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5000214"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2005.67127.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0902045"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.04.035"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2022.2020092"},{"issue":"5","key":"e_1_2_7_16_1","first-page":"121","article-title":"Femoropopliteal arterial dissections post flex vessel prep and adjunctive angioplasty. Results of the flex dissection study","volume":"31","author":"Shammas NW","year":"2019","journal-title":"J Invasive Cardiol"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1526602819849955"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/15266028211057089"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2016.07.015"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000508"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-044356"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znab301"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2015.05.001"},{"issue":"12","key":"e_1_2_7_24_1","first-page":"1290","article-title":"Paclitaxel\u2010coated balloon in the treatment of recurrent dysfunctional arteriovenous access, real\u2010world experience and longitudinal follow up","volume":"24","author":"Phang CC","year":"2019","journal-title":"Nephrol Ther"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211067046"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.12.062"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211033519"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-4758.2008.00246.x"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000203"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s42155-021-00271-1"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/1129729818814466"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-015-1190-4"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.08.018"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1914617"}],"container-title":["Hemodialysis International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hdi.13111","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T03:27:00Z","timestamp":1696303620000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hdi.13111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,17]]},"references-count":33,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1111\/hdi.13111"],"URL":"https:\/\/doi.org\/10.1111\/hdi.13111","archive":["Portico"],"relation":{},"ISSN":["1492-7535","1542-4758"],"issn-type":[{"value":"1492-7535","type":"print"},{"value":"1542-4758","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,17]]},"assertion":[{"value":"2023-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}