Treatment of hemodialysis-related central venous stenosis or occlusion: results of primary Wallstent placement and follow-up in 50 patients

Radiology. 1999 Jul;212(1):175-80. doi: 10.1148/radiology.212.1.r99jl21175.

Abstract

Purpose: To analyze the effectiveness of stent placement as the primary treatment for central venous obstruction in patients undergoing hemodialysis.

Material and methods: Fifty-seven Wallstents were placed in 50 patients with symptomatic shunt dysfunction and arm swelling due to central venous obstruction. Technical success, complication, and patency rates were evaluated.

Results: Stent deployment was successful in all patients, and early rethrombosis (within 1 week) was noted in one patient (2%). Seventy-three episodes of reobstruction occurred and were treated percutaneously with angioplasty alone in 54 cases (74%). Nineteen cases (26%) necessitated additional stent placement. The 3-, 6-, 12-, and 24-month primary patency rates were 92%, 84%, 56%, and 28%, respectively. Cumulative overall stent patency was 97% after 6 and 12 months, 89% after 24 months, and 81% after 36 and 48 months.

Conclusion: In the treatment of brachiocephalic and subclavian venous obstruction, stent placement shows excellent technical results and helps preserve vascular access for a substantial period. Multiple repeat interventions are, however, frequently required to maintain patency.

MeSH terms

  • Adult
  • Aged
  • Angiography
  • Angioplasty, Balloon / instrumentation
  • Catheterization, Central Venous*
  • Female
  • Follow-Up Studies
  • Graft Occlusion, Vascular / diagnostic imaging
  • Graft Occlusion, Vascular / therapy*
  • Humans
  • Male
  • Middle Aged
  • Renal Dialysis*
  • Retreatment
  • Stents*