<![CDATA[Background: Vascular access remains the main challenge in hemodialysis and is frequently complicated by stenosis and restenosis, necessitating effective interventions to maintain vascular patency. Cutting balloon angioplasty has emerged as a newer therapeutic modality. However, the effectiveness of cutting balloon angioplasty versus conventional balloon angioplasty is still an open question. This meta-analysis aims to provide an answer by collecting and analyzing the data available on the matter. Methods: Cutting balloon and conventional balloon angioplasty were compared in studies only if they were randomized controlled trials; otherwise, the study was non-randomized if high-pressure balloon angioplasty, paclitaxel-coated balloon angioplasty, and vascular access stenting were used. A systematic search was conducted in the databases of PubMed, Scopus, and Web of Science, and the last search was done on August 16, 2025. The studies that were selected were analyzed for bias risk employing the RoB 2 tool. The RevMan 5.4 software was used for data analysis, and the results were given as forest plots. Results: The final selection consisted of three randomized controlled trials that totaled 549 participants in the cutting balloon group and 536 in the conventional balloon group. The results showed that the target lesion at 6 months primary patency was higher for cutting balloon angioplasty than for conventional balloon angioplasty, with a relative risk of 1.21 (95% CI 1.03–1.40; p = 0.02). However, no significant differences in clinical and anatomical success were noted between the two groups (p>0.05). Conclusion: The study had limitations due to the comparatively small sample size, which may lead to limited generalizability. However, it also gave an indication that cutting balloon angioplasty might be the better option for treating arteriovenous shunt stenosis.]]>
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