Wallstent deployment to salvage dialysis graft thrombolysis complicated by venous rupture: early and intermediate results

AJR Am J Roentgenol. 1997 Nov;169(5):1435-7. doi: 10.2214/ajr.169.5.9353476.

Abstract

Objective: The feasibility of deploying Wallstents to treat venous rupture occurring during dialysis graft thrombolysis was determined.

Subjects and methods: Between June 24, 1994, and February 19, 1997, 23 patients with venous rupture attributed to balloon angioplasty during dialysis graft thrombolysis were treated by Wallstent deployment across the area of rupture. Twenty-one ruptures occurred in peripheral veins and two occurred in central veins. Follow-up was provided by the clinical service at our institution and by electronic review of patients' charts.

Results: Stent placement allowed completion of graft thrombolysis in all 23 patients. Complications were limited to four moderate-sized hematomas of the arm, and a single pseudoaneurysm developed 6 months after stent placement in one 27-year-old patient. The primary patency rate of stents was 52% at 60 days, 26% at 180 days, and 11% at 360 days. The secondary patency rate was 74% at 60 days, 65% at 180 days, and 56% at 360 days.

Conclusion: Treatment of venous ruptures using Wallstents is a safe alternative to intentional graft thrombosis. The patency rates of these devices are similar to those of venous stents placed for other indications.

MeSH terms

  • Aged
  • Angioplasty, Balloon / adverse effects*
  • Arteriovenous Shunt, Surgical
  • Extravasation of Diagnostic and Therapeutic Materials
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Graft Occlusion, Vascular / therapy*
  • Heparin / therapeutic use
  • Humans
  • Male
  • Polytetrafluoroethylene
  • Renal Dialysis*
  • Rupture
  • Stents*
  • Time Factors
  • Urokinase-Type Plasminogen Activator / therapeutic use
  • Veins / injuries

Substances

  • Polytetrafluoroethylene
  • Heparin
  • Urokinase-Type Plasminogen Activator