A systematic review of venoplasty versus stenting for the treatment of central vein obstruction in ipsilateral hemodialysis access

Andrawos, Alice; Saeed, Hani; Delaney, Christopher

doi:10.1016/j.jvsv.2021.02.014

Cited by 9 publications

(4 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although early studies have reported unfavorable patency outcomes associated with endovascular stenting in the treatment of CVOD, such as in a study by Gray et al 50 that reported primary patency of only 20% at 12 months after bare metal stenting, more recent studies with improved stent designs and constructions have actually achieved better outcomes. A recent systematic review by Andrawos et al 51 reported pooled 12-month primary patency, assisted primary patency, and secondary patency of 53.8%, 70.9%, and 94%, respectively, after endovascular stenting for the treatment of hemodialysis related CVOD. Similarly, Akkakrisee and Hongsakul 52 reported a primary patency of 61.8% at 12 months when a venous specific bare metal stent was used to treat CVOD.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of right atrial bypass grafting in the management of central venous occlusive disease in patients undergoing hemodialysis

et al. 2022

View full text Add to dashboard Cite

Introduction: Central venous occlusive disease (CVOD) is a complication that can occur in patients with end-stage renal disease who are receiving hemodialysis. When CVOD develops, patients often require multiple re-interventions to maintain their dialysis access. CVOD can be treated by various strategies such as balloon angioplasty, stenting, lower limb or extra-anatomical grafts, hybrid grafts or surgical bypasses such as right atrial (RA). In this systematic review, we aim to evaluate the indications, technical aspects, and outcomes after RA bypass grafting for the treatment of CVOD in hemodialysis patients. Methods: A systematic and comprehensive literature search was conducted using various electronic databases. We included articles that reported described and reported outcomes of RA bypass grafting for the treatment of CVOD in hemodialysis patients. A narrative review of the indications and technical aspects of RA bypass grafting was performed. We also pooled and reported the primary patency, secondary patency, postoperative complications, and 30-day mortality of RA bypass grafting. Results: A total of 21 studies with 55 patients who underwent RA bypass grafting were included in our systematic review. Follow-up period ranged from 0.5 to 84 months. The mean pooled primary patency and secondary patency of RA bypass grafting were 8.1 ± 4.9 and 21.7 ± 20.1 months, respectively. The incidence of early postoperative complications such as surgical site infection, bleeding, and access thrombosis was 0%, 4%, and 4%, respectively. The overall 30-day mortality was 4%. Conclusions: This systematic review summarizes the patient characteristics, technical features and outcomes of RA bypass grafting in the treatment of hemodialysis-related CVOD. RA bypass grafting may be a viable last-resort option when less invasive or conventional treatment options have been exhausted.

show abstract

Section: Discussionmentioning

confidence: 99%

A systematic review of right atrial bypass grafting in the management of central venous occlusive disease in patients undergoing hemodialysis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…CVO/CVS is a relatively common and vital problem in HD patients, which lead to a wide range of complications and even results in decreased long-term patency rates and shortened survival ( 1 , 3 ). Endovascular treatment, including PTA and stent placement, is the preferred treatment for CVO/CVS ( 7 , 10 ). The decisive factors affecting the difficulty of endovascular treatment of CVO/CVS and the duration of postoperative patency are key clinical concerns.…”

Section: Discussionmentioning

confidence: 99%

Clinical Implications of Phenotypes of Hemodialysis Patients With Central Venous Occlusion or Central Venous Stenosis Defined by Cluster Analysis

Wen

Chen

Lin

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

ObjectiveThis study aims to investigate the association between clinical factors of patients with central (superior vena cava, brachiocephalic, or subclavian) venous occlusion or central venous stenosis (CVO/CVS) and the difficulty of interventional recanalization as well as the duration of postoperative patency.MethodsA total of 103 hemodialysis patients with CVO/CVS treated with endovascular treatment were enrolled. The two-step cluster analysis was selected to differentiate the cases into distinct phenotypes automatically. Differences in characteristics, the difficulty of interventional recanalization, and the duration of postoperative primary patency time between the two clusters were statistically compared.ResultsThe 103 cases were divided into distinct two clusters by the two-step cluster analysis with 48 (46.6%) in cluster 1 and 55 (53.4%) in cluster 2. Compared to cluster 2, patients in cluster 1 have a higher proportion of blunt stump, side branches, occlusion lesions >2 cm, calcification, or organization. Moreover, the above four factors were, in turn, the most critical four predictors distinguishing 103 patients into two clusters. The remaining six factors were, in turn, occlusion located in the superior vena cava (SVC), duration of central venous catheterization (CVC), lesion location, vessel diameter, number of CVC, and previously failed lesion. Of the four most important factors, with the exception of occlusion lesions exceeding 2 cm, there were significant differences in the length of procedure time between the groups grouped by the remaining three factors. And there was a significant difference in the primary patency rate between the group with blunt stump and the group without blunt stump and also between the group with occlusion lesions ≥ 2 cm and the group with occlusion lesions <2 cm. The operation time of cluster 1 was longer than that of cluster 2. In terms of postoperative patency time, the primary patency time was significantly longer in the patients of cluster 2 compared with cluster 1 (P = 0.025).ConclusionPatients were divided into distinct two clusters. CVO/CVS of patients in cluster 1 was more challenging to be recanalized than that in cluster 2, and the primary patency time was significantly longer in the patients of cluster 2 compared with cluster 1. Blunt stump, side branches, occlusion lesions exceeding 2 cm, and calcification or organization are the four most critical predictors distinguishing 103 patients into two clusters.

show abstract

“…Em uma revisão sistemática recente, publicada em setembro de 2021 no Journal of Vascular Surgery: Venous and Lymphatic Disorders por Andrawos et al 18 , foram analisadas nove séries de casos e oito estudos tipo coorte, com resultados de patência primária geral de 60% em 1 ano. Os casos tratados com stent apresentaram superioridade na patência primária, considerando um período de até 2 anos de seguimento, sendo que a maioria dos casos tratados com stent (301 de 345 doentes) foi precedida de angioplastia com balão, sendo utilizado stent nos casos de estenose residual ou recoil.…”

Section: Discussionunclassified

Tratamento endovascular de doença oclusiva venosa central com fístula arteriovenosa funcionante

2022

View full text Add to dashboard Cite

Resumo Contexto A maior sobrevida dos doentes dialíticos somada à incapacidade de obtenção de órgãos suficientes para atender a demanda, bem como à dificuldade de acesso aos serviços de saúde, levou ao aumento da fila para transplante e ao prolongamento do tempo de utilização do acesso venoso central para hemodiálise. A etiologia mais comum de estenose de veia central é o acesso venoso central prolongado, pelas lesões intimais decorrentes da presença do cateter. Objetivos Avaliar resultados de angioplastia para tratamento de doença oclusiva venosa central com fístula arteriovenosa periférica funcionante. Métodos Estudo tipo coorte retrospectivo com revisão de prontuários de 47 doentes com lesões estenóticas ou oclusivas. A avaliação dos doentes foi realizada em 30 dias, 6 meses e 1 ano após a recanalização ou correção da estenose com ATP ou ATP/aplicação de stent. Resultados Lesões estenóticas foram encontradas em 25 doentes (53%), e oclusões, em 22 (47%) doentes. A angioplastia percutânea transluminal (ATP) com stent foi utilizada em 64% dos doentes, e angioplastia isolada com balão, em 36% deles. A análise de resultados clínicos mostrou elevada taxa de melhora clínica precoce (30 dias) em 82% dos doentes (intervalo de confiança [IC] 71-93%). Após 1 ano de seguimento, a taxa de perviedade primária foi de 57%, e a taxa de perviedade primária assistida foi de 72% (IC 57-84%). Conclusão O tratamento endovascular das estenoses ou oclusões de veia central sugere melhora clínica dos sintomas e taxas adequadas de perviedade no período de 1 ano, apesar da limitação no tamanho amostral.

show abstract

A systematic review of venoplasty versus stenting for the treatment of central vein obstruction in ipsilateral hemodialysis access

Cited by 9 publications

References 35 publications

A systematic review of right atrial bypass grafting in the management of central venous occlusive disease in patients undergoing hemodialysis

A systematic review of right atrial bypass grafting in the management of central venous occlusive disease in patients undergoing hemodialysis

Clinical Implications of Phenotypes of Hemodialysis Patients With Central Venous Occlusion or Central Venous Stenosis Defined by Cluster Analysis

Tratamento endovascular de doença oclusiva venosa central com fístula arteriovenosa funcionante

Contact Info

Product

Resources

About