Access-Related venous stenoses and occlusions: Treatment with percutaneous transluminal angioplasty and dacron-covered stents

Farber, A.; Barbey, M.-M.; Grunert, Jens-Holger; Gmelin, E

doi:10.1007/s002709900369

Cited by 33 publications

(19 citation statements)

References 14 publications

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“…Only a few articles described metallic stent placement in native AV fistulas and in only a small number of patients (4). Farber et al (7) treated peripheral venous lesions with a Dacron (Du-Pont)-covered stent in five AV fistula dialysis patients. The primary and secondary patency rates were 57% and 83%, respectively at 6 months, and 29% and 53%, respectively at the end of the first year.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Stent Placement of Juxtaanastomotic Stenosis in Native Arteriovenous Fistula After Unsuccessful Balloon Angioplasty

et al. 2013

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BackgroundIn hemodialysis patients, the most common problem in arteriovenous fistulas, as the best functional vascular access, is the juxtaanastomotic located lesions. Percutaneous transluminal angioplasty is accepted as the treatment method for juxtanastomotic lesions.ObjectivesTo assess juxtaanastomotic stent placement after insufficient balloon angioplasty in the treatment of autogenous radiocephalic or brachiocephalic fistula dysfunction.Patients and MethodsBetween July 2003 and June 2010, 20 hemodialysis patients with autogenous radiocephalic or brachiocephalic fistula dysfunction underwent stent placement for the lesion located at the juxtaanastomotic region. Indications for stent placement were insufficient balloon dilatation, early recurring stenosis, chronic organizing thrombus and vessel rupture. The Kaplan-Meier method was used to calculate the stent patency rates. All patients who had fistula dysfunction (thrombosis of hemodialysis access, difficult access cannulation, extremity pain due to thrombosis or decreased arterial access blood flow) were evaluated by color Doppler ultrasound. The stenoses were initially dilated with standard noncompliant balloons (3 to 10-mm in diameter). Dilatation was followed by high pressure (Blue Max, Boston Scientific) or cutting balloons (Boston Scientific), if the standard balloon failed to dilate the stenotic segment.ResultsTwenty-one stents were applied. The anatomical and clinical success rate was 100%. Seventeen additional interventions were done for 11 (55%) patients due to stent thrombosis or stenosis during follow-up. Our 1- and 2-year secondary patency rates were 76.2% and 65.5%, respectively and were comparable to those after balloon angioplasty and surgical shunt revision.ConclusionMetallic stent placement is a safe and effective procedure for salvage of native hemodialysis fistula after unsuccessful balloon angioplasty.

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Section: Discussionmentioning

confidence: 99%

Endovascular Stent Placement of Juxtaanastomotic Stenosis in Native Arteriovenous Fistula After Unsuccessful Balloon Angioplasty

et al. 2013

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“…[12][13][14] The experience reported for stenotic or occlusive lesions is limited to small series. 11,[15][16][17] The aim of this study was to evaluate the efficacy and durability of covered stents in treating CVOD to restore the venous outflow, preserving a functional arteriovenous (AV) dialysis access circuit.…”

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confidence: 99%

Efficacy of covered stent placement for central venous occlusive disease in hemodialysis patients

Anaya‐Ayala

Smolock

Colvard

et al. 2011

Journal of Vascular Surgery

103

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“…5,[8][9][10] Using a covered stent or the use of endovascular brachytherapy seems not to enhance the patency rate. 11,12) Several anatomical changes inside the central veins may predispose to PTA failure. Long-standing stenosis may provoke vein fibrosis and occlusion of long venous segments.…”

Section: Discussionmentioning

confidence: 99%

Ipsilateral Jugular to Distal Subclavian Vein Transposition to Relieve Central Venous Hypertension in Rescue Vascular Access Surgery: A Surgical Report of 3 Cases

Acri

Carmignani

Vazzana

et al. 2013

ATCS

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Central venous thrombosis may often arise following central venous cannulation for temporary haemodialysis access. Venous thrombosis may be clinically asymptomatic due to the presence of collateral circulation. However, if an arteriovenous (AV) fistula is prepared below the obstructed venous segment, then symptoms may occur. Central venous hypertension interferes with dialysis, compromises limb function and threatens its safety. Percutaneous treatment is mostly used. However, in some cases endovascular treatment may not be as easy and long term patency uncertain. We report our experience on 3 patients on chronic hemodialysis treatment presenting with a patent AV fistula and ipsilateral subclavian vein chronic fibrotic obstruction. They were treated by ipsilateral internal jugular to distal subclavian vein transposition. Two separate surgical incisions were performed to expose the subclavian vein distally to the occlusion and the jugular vein that was distally ligated and transposed. There was no mortality nor significant postoperative complications. Resolution of hypertensive symptoms was achieved within 3-4 weeks in all patients. The AV fistula was used for dialysis treatment starting from the first postoperative day. At follow-up (mean 13 months), there was no recurrence of upper limb venous hypertension. In patients with subclavian occlusion and ipsilateral low flow, patent AV fistula, jugular to distal subclavian vein transposition may prove useful in cases when percutaneous angioplasty is technically not feasible or long term patency is not expected.

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Access-Related venous stenoses and occlusions: Treatment with percutaneous transluminal angioplasty and dacron-covered stents

Abstract: Percutaneous placement of Dacron-covered stents is a safe and effective procedure for salvage of a dialysis fistula. First results are promising, with a tendency to prolongation of the time interval between reinterventions.

Cited by 33 publications

References 14 publications

Endovascular Stent Placement of Juxtaanastomotic Stenosis in Native Arteriovenous Fistula After Unsuccessful Balloon Angioplasty

Endovascular Stent Placement of Juxtaanastomotic Stenosis in Native Arteriovenous Fistula After Unsuccessful Balloon Angioplasty

Efficacy of covered stent placement for central venous occlusive disease in hemodialysis patients

Ipsilateral Jugular to Distal Subclavian Vein Transposition to Relieve Central Venous Hypertension in Rescue Vascular Access Surgery: A Surgical Report of 3 Cases

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