Role of stents in hemodialysis vascular access

J Vasc Access. 2018 Jul;19(4):341-345. doi: 10.1177/1129729818761280. Epub 2018 Mar 12.


Stents are ubiquitously utilized in coronary and peripheral arterial disease. Interventional nephrologists, however, place stents in the venous outflow of the arteriovenous access. Stenosis is the predominant pathology that causes access dysfunction and will ultimately lead to thrombosis if uncorrected. Angioplasty and stent deployment are the current techniques available to combat stenosis. From initial bare metal stainless steel stents, the current generations of stents used are predominately covered nitinol stents. The latest randomized control trials reveal that stents decrease the number of interventions required to maintain patency but do not improve the overall access survival. Furthermore, bare metal stents have been shown to be inferior to stent grafts. This review discusses indications for stent deployment in the hemodialysis access, the current evidence for their use, and briefly touches on their complications.

Keywords: Stents; angioplasty; hemodialysis vascular access.

Publication types

  • Review

MeSH terms

  • Aneurysm, False / etiology
  • Aneurysm, False / physiopathology
  • Aneurysm, False / therapy*
  • Angioplasty / adverse effects
  • Angioplasty / instrumentation*
  • Arteriovenous Shunt, Surgical / adverse effects*
  • Catheterization, Central Venous / adverse effects*
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / physiopathology
  • Graft Occlusion, Vascular / therapy*
  • Humans
  • Prosthesis Design
  • Renal Dialysis*
  • Risk Factors
  • Stents*
  • Treatment Outcome
  • Upper Extremity Deep Vein Thrombosis / etiology
  • Upper Extremity Deep Vein Thrombosis / physiopathology
  • Upper Extremity Deep Vein Thrombosis / therapy*
  • Vascular Patency