BackgroundCentral vein stenosis or occlusion is a common complication that can lead to significant morbidity and dysfunction of access in the hemodialysis patient. More lesions can develop over time, and preserving access becomes a challenge as life expectancy of the hemodialysis patient increases.ObjectivesThe goal was to compare long-term results and determine the outcomes of open-cell stent versus closed-cell stent for central vein stenosis or occlusion in hemodialysis patients.Patients and MethodsFrom 1997 to 2015, in 401 hemodialysis patients, stent placement for central vein stenosis or occlusion was performed if balloon angioplasty was unsatisfactory, due to elastic recoil or occurrence of restenosis within 3 months. When thrombus was present, primary stenting was performed. A total of 257 open-cell stents and 144 closed-cell stents were used. Angiographic findings including lesion site, central vein stenosis or occlusion, and presence of thrombosis and complication were evaluated. Primary patency rate and mean patency rate of the stent were compared between two stent groups by Kaplan-Meier survival analysis.ResultsFor the open-cell stent group, 159 patients were diagnosed as central vein stenosis and 98 were occlusion. For the closed-cell stent group, 78 were stenosis and 66 were occlusion. There were two complications for central migration and two for procedure-related vein rupture. Open-cell stents and closed-cell stents had mean patency rates of 10.9 ± 0.80 months and 8.5 ± 10.87 months, respectively (P = 0.002).ConclusionThe open-cell stent is effective and its performance is higher than that obtained with the closed-cell stent for treating central vein stenosis or occlusion in hemodialysis patients.

Objectives To present the radiological and clinical results of transcatheter arterial embolization in patients with active bleeding after percutaneous renal procedures. Methods A total of 79 consecutive patients who underwent angiography for percutaneous renal procedure‐related bleeding were included in the present retrospective analysis. Patient characteristics, angiographic management and clinical outcomes were analyzed. Results On angiography, bleeding foci were observed in 81.0% of the patients (64/79), all of whom underwent transcatheter arterial embolization. Among the 15 patients (19.0%) with negative angiographic findings, empirical transcatheter arterial embolization was carried out in six patients (40.0%). The technical success rate in 64 patients with positive angiographic findings was 100%, and the clinical success rate in 70 patients who underwent transcatheter arterial embolization was 85.7% (60/70). A total of 14.3% (10/70) of patients with clinical failure underwent repeat transcatheter arterial embolization and all achieved clinical recovery. There were no major complications. There was no statistical difference in estimated glomerular filtration rate values before the percutaneous renal procedure and those measured 7 days after transcatheter arterial embolization (43.4 ± 24.4 to 44.6 ± 25.1 mL/min/1.73 m2; P = 0.189). Clinical failure was not associated with age, sex, type of renal procedures, bleeding tendency, presence of active bleeding on angiography, latency time and embolic agents used (P > 0.05). Conclusions Transcatheter arterial embolization is a safe and effective method of treating percutaneous renal procedure‐related bleeding without renal function deterioration.

A 67-year-old woman presented with memory impairment and behavioral changes. Brain MRI indicated hepatic encephalopathy. Abdominal CT scans revealed an intrahepatic portosystemic venous shunt that consisted of two shunt tracts to the aneurysmal sac that communicated directly with the right hepatic vein. The large tract was successfully occluded by embolization using the newly available AMPLATZERTM Vascular Plug II and the small tract was occluded by using coils. The patient's symptoms disappeared after shunt closure and she remained free of recurrence at the 3-month follow-up evaluation.

Fluoroscopy-guided percutaneous Foley catheter placement may be a safe and effective treatment option for postoperative duodenal stump leakage and may allow for shorter hospital stays, earlier oral intake, and more effective control of leakage sites.