Drug-Coated Balloon for Arteriovenous Access Stenosis in Hemodialysis Patients

Round 1

Reviewer 1 Report

In the manuscript “Drug-coated balloon for arteriovenous access stenosis in hemodialysis patients”, Kim summarized the published information about drug-coated balloons for dialysis access stenosis. The author described the two types of drug (paclitaxel and sirolimus)-coated balloons in arteriovenous stenosis. Data from randomized control trials and systematic reviews have been included in this Review. The controversial conclusions among different trials and studied were well-presented and organized. The safety concern of paclitaxel-based drug-coated balloons was discussed. Overall, this review collected current evidences on the role of drug-coated balloons in the treatment of hemodialysis access stenosis.

Are there any differences between stenosis before and after angioplasty?

Author Response

Point 1: In the manuscript “Drug-coated balloon for arteriovenous access stenosis in hemodialysis patients”, Kim summarized the published information about drug-coated balloons for dialysis access stenosis. The author described the two types of drug (paclitaxel and sirolimus)-coated balloons in arteriovenous stenosis. Data from randomized control trials and systematic reviews have been included in this Review. The controversial conclusions among different trials and studied were well-presented and organized. The safety concern of paclitaxel-based drug-coated balloons was discussed. Overall, this review collected current evidences on the role of drug-coated balloons in the treatment of hemodialysis access stenosis.

Are there any differences between stenosis before and after angioplasty?

 

 

Response 1: Thank you for your comment. I agree with the reviewer’s point that it is important to know how the characteristics of the stenotic lesion that develops after the use of a drug-coated balloon differ from those of the stenosis before the treatment, especially histologically. Unfortunately, none of the studies to date have analyzed this aspect. Future research on this topic is required.

Reviewer 2 Report

The author provided a narrative review about drug-coated balloon use for arteriovenous fistula (AVF) stenosis in patients with end-stage renal disease (ESRD). Several comments are listed below.

 

1. The author should add a table outlining currently available drug-coated balloons (in market or in trials, different drugs, length, pressure, etc.), preferably in Section 2. A schematic figure describing how drug-coated balloon is deployed over stenotic site, or even a video, is also needed to facilitate readers understanding the content of this review.
2. The English styles need much improvement. Multiple typos exist throughout the manuscript and need correction. Ex. line 33, “myofibrobroblast”. In addition, many words are of unclear meaning, such as “the inherent status of dialysis patients” (line 29), and many more. Please send the manuscript for Professional English editing, or the manuscript cannot be deemed appropriate.

Author Response

Point 1: The author should add a table outlining currently available drug-coated balloons (in market or in trials, different drugs, length, pressure, etc.), preferably in Section 2. A schematic figure describing how drug-coated balloon is deployed over stenotic site, or even a video, is also needed to facilitate readers understanding the content of this review.

 

 

Response 1: Thank you for your comment. Accordingly, we have added a table outlining the currently available drug-coated balloons in Section 2 along with a schematic figure.

 

 

Point 2: The English styles need much improvement. Multiple typos exist throughout the manuscript and need correction. Ex. line 33, “myofibrobroblast”. In addition, many words are of unclear meaning, such as “the inherent status of dialysis patients” (line 29), and many more. Please send the manuscript for Professional English editing, or the manuscript cannot be deemed appropriate.

 

Response 2: The manuscript has undergone professional English editing as recommended.

Reviewer 3 Report

The author presented a review article on the use of drug-eluting
balloons in the treatment of stenosis of arteriovenous fistulas. Numerous recent
randomized controlled trials were discussed and review articles were cited.
The topic is discussed clearly and in detail. The problem is current, but it
adds nothing novel other than a research summary. I would suggest to
remove the information about target lesion revascularization related to ref. 46.
It is confusing.

Author Response

Point 1:  The author presented a review article on the use of drug-eluting balloons in the treatment of stenosis of arteriovenous fistulas. Numerous recent randomized controlled trials were discussed and review articles were cited. The topic is discussed clearly and in detail. The problem is current, but it adds nothing novel other than a research summary. I would suggest to remove the information about target lesion revascularization related to ref. 46. It is confusing.

 

Response 1: Thank you for your comment. We have removed the information regarding target lesion revascularization related to reference 46 from Page 4 and Table 2.

Round 2

Reviewer 2 Report

Thank you. The manuscript has been improved considerably.