Endovascular Treatment of Central Vein Stenoses and/or Occlusions in Hemodialysis Patients

Journal Article · Sat Feb 15 04:00:00 EST 2003 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-002-1960-7· OSTI ID:21088425

Maskova, Jana; Komarkova, Jana; Kivanek, Jiri; Danes, Jan ^[1]; Slavikova, Marcela ^[2]

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1. Department of Radiology, University Hospital, Unemocnice 2, Prague 2, 12800 (Czech Republic)
2. Departmentof Cardiovascular Surgery, University Hospital, Unemocnice 2, Prague 2, 12800 (Czech Republic)

Purpose: To report our experience and results with the endovascular treatment of central vein stenoses and occlusions in hemodialysis patients. Methods: Between October 1999 and August 2001 (22 months) we performed 22 interventional procedures in 14 hemodialysis patients (8 women, 6 men) ranging in age from 38 to 87 years (mean 76 years). The indication for intervention was stenosis (n = 10) or occlusion (n =4) of a central vein in the upper arm used for dialysis inpatients with arm swelling and/or shunt malfunction. All patients had a previous history of subclavian vein cannulation. There were six percutaneous transluminal angioplasties (PTAs) and eight primary stentplacements and eight repeat interventions. Seven were for restenoses and one for early occlusion, with two secondary stent placements and six PTA of in-stent stenoses. In two patients a second stent was implanted. The mean follow-up was 8.5 months (range 1-19 months). All stents were self-expandable with diameters ranging from 9 to 16 mm. Results: All but one of the procedures was technically successful (95%, n = 21). The patient with an unsuccessful procedure died 1 month after the procedure, but the death was not procedure-related. During follow-up three patients died with a patent shunt and central vein, none of them in connection with the procedure. No complication occurred during the interventional procedures. One patient was lost to follow-up. The primary patency rate at 12 months was 43%, with a primary assisted patency rate of 83% and a secondary patency rate of 100% (n 6). Conclusion: Central vein stenoses and occlusions are associated with previous subclavian vein cannulation. They are a serious problem in hemodialysis patients with a shunt on the same arm.Endovascular treatment is a suitable option for these patients.

• OSTI ID: 21088425
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 1 Vol. 26; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BYPASSES
DIALYSIS
PATIENTS
SWELLING
VEINS