Paclitaxel retention of drug-coated balloons in veins and arteries under arteriovenous fistula hemodynamics

Introduction

Arteriovenous fistulas (AVFs) are the preferred vascular access for hemodialysis, but venous stenosis remains a major limitation to long-term patency. Drug-coated balloons (DCBs) have emerged as a promising therapy to inhibit neointimal hyperplasia and reduce restenosis. However, inconsistent clinical outcomes have limited their adoption for AVF stenosis. The unique AVF environment-characterized by high flow, turbulent shear stress, and alternating arterial and venous segments-may influence drug transfer and retention within the vessel wall. Despite its importance, the impact of tissue type under AVF-specific hemodynamics on DCB performance remains poorly understood. This study investigates paclitaxel retention in venous and arterial tissue under simulated AVF conditions using an ex vivo bioreactor system.