{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T14:21:30Z","timestamp":1762093290310,"version":"build-2065373602"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Hemodialysis vascular accesses are susceptible to restenosis, requiring frequent interventions to maintain patency. Stent-grafts (SGs) have been shown to improve patency and are already approved for use in this setting. This study aims to compare the off-label use of drug-eluting stents (DESs) versus SGs in managing hemodialysis vascular access outflow stenosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This single-center retrospective study reviewed patients treated with DES or SG for vascular access outflow stenosis. The primary outcome was the comparison of patency rates between DES and SG groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 156 patients were treated with either DES (n = 60 DES) or SG (n = 106 SG). DES deployment significantly reduced the mean number of target-lesion interventions (TLI) from 2.4 to 0.7 per year (p&lt;0.001) and extended median TLI-free time from 4 to 10 months (p&lt;0.001). Similarly, SG reduced mean TLI from 1.3 to 0.7 per year (p&lt;0.001), increasing TLI-free time from 4 to 13 months (p&lt;0.001). At 12 months, DES primary, assisted primary, and secondary patency rates were 49.9%, 78.2%, and 96.7%, respectively, compared to 58.8% (p=0.198), 72.3% (p=0.264), and 96.9% (p=0.877) for SGs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>DES and SG significantly reduced TLI rates and prolonged TLI-free intervals compared to plain balloon angioplasty (PBA). No significant differences in overall patency were observed between the devices. These findings support DES as a potential alternative for managing outflow stenosis, particularly in venous confluent sites, where the risk of outflow jailing may compromise future vascular access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Impact<\/jats:title>\n                    <jats:p>This study suggests a potential paradigm shift in managing venous outflow lesions in dialysis access. By demonstrating comparable patency between drug-eluting stents (DES) and stent-grafts (SG), it broadens clinicians\u2019 options, particularly in anatomically challenging or recurrent stenoses. The innovation lies in identifying DES as a viable, off-label alternative that preserves future access possibilities by avoiding venous \u201cjailing,\u201d a limitation of SGs. For clinicians, this means a more flexible, patient-tailored endovascular strategy that extends time to reintervention, optimizes long-term patency, and supports access preservation\u2014especially valuable in cases requiring future surgical options like brachiobasilic fistula creation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028251384926","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T12:55:51Z","timestamp":1761828951000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Drug-Eluting Stents vs. Stent-Grafts in Hemodialysis Vascular Access Outflow Interventions"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7870-7044","authenticated-orcid":false,"given":"Andreia","family":"Pinelo","sequence":"first","affiliation":[{"name":"Grupo de Estudos Vasculares, Vascular Access Center, Porto, Portugal"},{"name":"Department of Angiology and Vascular Surgery, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9740-018X","authenticated-orcid":false,"given":"Lu\u00eds","family":"Loureiro","sequence":"additional","affiliation":[{"name":"Grupo de Estudos Vasculares, Vascular Access Center, Porto, Portugal"},{"name":"Department of Angiology and Vascular Surgery, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5460-012X","authenticated-orcid":false,"given":"Daniel","family":"Mendes","sequence":"additional","affiliation":[{"name":"Grupo de Estudos Vasculares, Vascular Access Center, Porto, Portugal"},{"name":"Department of Angiology and Vascular Surgery, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"}]},{"given":"Duarte","family":"Rego","sequence":"additional","affiliation":[{"name":"Grupo de Estudos Vasculares, Vascular Access Center, Porto, Portugal"},{"name":"Department of Angiology and Vascular Surgery, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7752-4169","authenticated-orcid":false,"given":"S\u00e9rgio","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Grupo de Estudos Vasculares, Vascular Access Center, Porto, Portugal"},{"name":"Department of Angiology and Vascular Surgery, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2476-7428","authenticated-orcid":false,"given":"Carlos","family":"Veterano","sequence":"additional","affiliation":[{"name":"Grupo de Estudos Vasculares, Vascular Access Center, Porto, Portugal"},{"name":"Department of Angiology and Vascular Surgery, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"}]},{"given":"Gabriela","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Grupo de Estudos Vasculares, Vascular Access Center, Porto, Portugal"},{"name":"Department of Angiology and Vascular Surgery, Unidade Local de Sa\u00fade do T\u00e2mega e Sousa, Guilhufe, Portugal"}]},{"given":"Carlos","family":"Veiga","sequence":"additional","affiliation":[{"name":"Grupo de Estudos Vasculares, Vascular Access Center, Porto, Portugal"},{"name":"Department of Angiology and Vascular Surgery, Unidade Local de Sa\u00fade de Braga, Braga, Portugal"}]},{"given":"Rui","family":"Machado","sequence":"additional","affiliation":[{"name":"Grupo de Estudos Vasculares, Vascular Access Center, Porto, Portugal"},{"name":"Department of Angiology and Vascular Surgery, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2654-0497","authenticated-orcid":false,"given":"Clemente","family":"Sousa","sequence":"additional","affiliation":[{"name":"Grupo de Estudos Vasculares, Vascular Access Center, Porto, Portugal"},{"name":"Escola Superior de Enfermagem do Porto, Porto, Portugal"}]},{"given":"Ant\u00f3nio","family":"Norton de Matos","sequence":"additional","affiliation":[{"name":"Grupo de Estudos Vasculares, Vascular Access Center, Porto, Portugal"}]},{"given":"Paulo","family":"Almeida","sequence":"additional","affiliation":[{"name":"Grupo de Estudos Vasculares, Vascular Access Center, Porto, Portugal"},{"name":"Department of Angiology and Vascular Surgery, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"}]}],"member":"179","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"e_1_3_3_2_2","article-title":"KDOQI clinical practice guideline for vascular access: 2019 update","volume":"75","author":"Lok CE","year":"2020","unstructured":"Lok CE, Huber TS, Lee T, et al. KDOQI clinical practice guideline for vascular access: 2019 update. Am J Kidney Dis J Natl Kidney Found. 2020;75(4 Suppl 2):S1-s164.","journal-title":"Am J Kidney Dis J Natl Kidney Found"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2018.02.001"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0902045"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2016.1254548"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2011.41.9.512"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2022.03.606"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1742483"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1051-0443(95)71200-3"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1993.122"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2023.11.010"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.5758\/vsi.2019.35.4.225"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvscit.2021.03.007"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12993"},{"key":"e_1_3_3_15_2","article-title":"Reporting standards for percutaneous interventions in dialysis access","volume":"14","author":"Gray RJ","year":"2003","unstructured":"Gray RJ, Sacks D, Martin LG, et al. Reporting standards for percutaneous interventions in dialysis access. J Vasc Int Radiol: JVIR. 2003;14(9 Pt. 2): S433\u2013S442.","journal-title":"J Vasc Int Radiol: JVIR"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2018.01.030"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.03.015"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2022.02.008"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2016.06.014"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298231174263"},{"key":"e_1_3_3_21_2","article-title":"Drug-eluting stent versus interwoven bare-metal stent in clinically significant vein-graft anastomotic stenosis of hemodialysis arteriovenous graft","author":"Hongsakul K","year":"2024","unstructured":"Hongsakul K, Khantayanuwong S, Sungsiri J, et al. Drug-eluting stent versus interwoven bare-metal stent in clinically significant vein-graft anastomotic stenosis of hemodialysis arteriovenous graft. 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