Dialysis Interventions with Drug-Coated Balloons, Covered Stents and More
Episode Summary
Dr. Ari Kramer was recently on the BackTable VI Podcast with Dr. Chris Beck. They discussed his management of arteriovenous (AV) access for dialysis patients. Episode 292, titled “Dialysis Interventions with Drug-Coated Balloons, Covered Stents and More,” can be found on the BackTable website, Spotify, Apple Podcasts and YouTube.
In this episode, Dr. Kramer describes his vascular access practice. He is the sole operator within a hospital-based practice where he creates and maintains AV access. Dr. Kramer also offers fistulagram tips and describes his procedure in an AV fistula circuit.
Dr. Kramer and Dr. Beck then discuss the clinical trials outcomes of the two current DCBs that have been approved for use in AV management, IN.PACT and Lutonix. Dr. Kramer also notes the significant cost of DCBs and lack of access to treatment for the most at-risk patients. He encourages clinicians to unite to advocate for increased reimbursement for this treatment that has been proven to show the highest standard of care.
To conclude the episode, Dr. Kramer and Dr. Beck discuss the treatment of non-autogenous AV circuits with stent grafts. Dr. Kramer prefers self-expanding covered stents, such as Viabahn or Covera, since they are conformable and resistant to kinks. Overall, Dr. Kramer emphasizes the importance of the operator staying up to date on clinical trials that show data for diverse tools with various indications, knowing their own skill and comfort, and incorporating the best treatments based on their patient and practice context.
About BackTable VI Podcast
The BackTable VI podcast was developed to help interventional radiologists, vascular surgeons, interventional cardiologists, and other interventional and endovascular specialists level up their day-to-day practice. Tune in to the BackTable Interventional Radiology Podcast.
