The fact that high-dose paclitaxel coated ballons can increase the median time to intervention from 3 to almost 8 months and then, if stenosis recurs, have virtually the same efficacy and effectiveness the second time around is truly impressive. However, is a median time of 3 months at which 50% of plain angioplasties require reintervention a reasonable value across various centers doing . I am not an interventionalist but this figure of 3 months after plain angioplasty seems short to me until reintervention is needed. Do we know what degree of residual stenosis was left after that plain angioplasty. Was a residual of < 30% from the previous angioplasty a criterion to enter the study using high dose paclitaxel DCB ? Study enrolled both native and Graft AVF.

I am not impressed that stenosis was estimated visually.

The mean age of the patients was elderly (72 years [SD } 12]; 67.4% male). The most frequent type of AVF was radial cephalic AVF (77.5%), and the most
common lesion location was the swing point (41.6%).Stenosis initially was 90%. Noncompliant balloons were used for predilution in 58.7% of patients. Is this something that is done with DCB or in plain angioplasty as well?

We know nothing about the degree of stenos in the initial stenosis, its length and whether non-compliant balloons were used to predilate. Partial lesion coverage and residual stenosis of >30% were observed in 17 (5.1%) and 11 (3.3%) patients, respectively. We do not know how many interventions per patient were done using plain angioplasty before the first paclitaxel DCB.

Reintervention following the initial DCG angioplasty WAS NEEDEDIN 178 pts using either DCG (84 pts) or plain angioplasty (894, pts. The median interval till recurrence was 3.3 mo (same as originally) for plain and 7.1 months for DCB angioplasty. In my experience, the interval between interventions in pts with native AVF and grafts tends to shorten over time as reinterventions become m

Limitations of the study are welll described particular vulnerable to bias by the treating physicians

Stuyi is from Japan where prevalence of native AVF is much higher, management of anemia and metabolic bone disease different from that in the west. Whether rheological flow difference and propensity to calcify vessels influences vascular access malfunction is unknown.

The fact that high-dose paclitaxel coated ballons can increase the median time to intervention from 3 to almost 8 months and then, if stenosis recurs, have virtually the same efficacy and effectiveness the second time around is truly impressive. However, is a median time of 3 months at which 50% of plain angioplasties require reintervention a reasonable value across various centers doing . I am not an interventionalist but this figure of 3 months after plain angioplasty seems short to me until reintervention is needed. Do we know what degree of residual stenosis was left after that plain angioplasty. Was a residual of < 30% from the previous angioplasty a criterion to enter the study using high dose paclitaxel DCB ? Study enrolled both native and Graft AVF.

I am not impressed that stenosis was estimated visually.

The mean age of the patients was elderly (72 years [SD } 12]; 67.4% male). The most frequent type of AVF was radial cephalic AVF (77.5%), and the most
common lesion location was the swing point (41.6%).Stenosis initially was 90%. Noncompliant balloons were used for predilution in 58.7% of patients. Is this something that is done with DCB or in plain angioplasty as well?

We know nothing about the degree of stenos in the initial stenosis, its length and whether non-compliant balloons were used to predilate. Partial lesion coverage and residual stenosis of >30% were observed in 17 (5.1%) and 11 (3.3%) patients, respectively. We do not know how many interventions per patient were done using plain angioplasty before the first paclitaxel DCB.

Reintervention following the initial DCG angioplasty WAS NEEDEDIN 178 pts using either DCG (84 pts) or plain angioplasty (894, pts. The median interval till recurrence was 3.3 mo (same as originally) for plain and 7.1 months for DCB angioplasty. In my experience, the interval between interventions in pts with native AVF and grafts tends to shorten over time as reinterventions become m

Limitations of the study are welll described particular vulnerable to bias by the treating physicians

Stuyi is from Japan where prevalence of native AVF is much higher, management of anemia and metabolic bone disease different from that in the west. Whether rheological flow difference and propensity to calcify vessels influences vascular access malfunction is unknown.