Venous stenosis and occlusion in hemodialysis shunts: follow-up results of stent placement in 65 patients

Radiology. 1995 Apr;195(1):140-6. doi: 10.1148/radiology.195.1.7892456.

Abstract

Purpose: To provide follow-up data on the use of self-expanding stents in hemodialysis fistulas to improve the technical success of balloon angioplasty.

Materials and methods: Ninety-two self-expanding vascular stents were placed in 65 patients (29 men and 36 women 25-79 years of age; mean, 57.6 years) with failing hemodialysis fistulas or shunts.

Results: Stent placement was successful in all patients, but rethrombosis of the shunt occurred in six patients (10%) within 1 week. There were 96 episodes of reobstruction. In 87 cases, percutaneous or combined surgical and percutaneous repeat intervention was performed. The cumulative shunt function rate was 88% after 6 months, 86% after 1 year, and 77% after 2 years.

Conclusion: Stent placement in hemodialysis fistulas helps treat lesions that cannot be adequately treated with percutaneous transluminal angioplasty (PTA) alone but has a follow-up patency rate similar to that of PTA. Standard central venous stents have a better patency rate than after PTA.

MeSH terms

  • Adult
  • Aged
  • Angioplasty, Balloon*
  • Arm / blood supply
  • Arteriovenous Shunt, Surgical
  • Constriction, Pathologic / diagnostic imaging
  • Constriction, Pathologic / therapy
  • Female
  • Follow-Up Studies
  • Graft Occlusion, Vascular / diagnostic imaging
  • Graft Occlusion, Vascular / therapy*
  • Humans
  • Male
  • Middle Aged
  • Polytetrafluoroethylene*
  • Radiography
  • Recurrence
  • Renal Dialysis*
  • Stents*
  • Time Factors
  • Vascular Patency

Substances

  • Polytetrafluoroethylene