Central Vein Obstruction in Vascular Access

Abstract

Central venous obstruction has become a major problem because of the frequent need for central venous catheters in haemodialysis patients. This article discusses the epidemiology and clinical features of central venous obstruction and the different surgical and interventional alternatives for its treatment.

Central vein stenosis in an Asian hemodialysis population

“…The primary patency was 52% at one year, a rate comparable to those of other studies, where 12-month primary patencies of 11%-71% have been achieved. 16 This observational study has several limitations. Firstly, cases were only included if they were symptomatic or had CVS diagnosed incidentally, and follow-up imaging after central vein angioplasty was reserved for those with recurrent symptoms.…”

Ultrasonography in Vascular Diagnosis

“…Venous obstruction often occurs secondary to central venous interventions or catheters, which may be associated with recanalized thrombosis and sclerosis. The primary patency rate after PTA alone is only 7-43% versus 11-70% for PTA with stenting (Mickley 2006). Color duplex imaging is also the method of choice for postinterventional evaluation of the shunt vein and central venous outflow.…”

Angioplasty with stent graft versus bare stent for recurrent cephalic arch stenosis in autogenous arteriovenous access for hemodialysis: A prospective randomized clinical trial

“…4 No prospective studies have been done on endovascular intervention for central vein stenosis or occlusion, but bare stents have demonstrated better patency rates than PTA alone in most studies. 5 Even after stent placement, neointimal hyperplasia is still the major reason for restenosis. 6 The cephalic vein forms part of the outflow conduit for radial-cephalic autogenous AVAs and is the sole outflow conduit for brachial-cephalic autogenous AVAs.…”