Endovascular stent placement in the treatment of upper extremity central venous obstruction in hemodialysis patients

Aytekin, Cüneyt; Boyvat, Fatih; Yağmurdur, Mahmut Can; Moray, Gökhan; Haberal, Mehmet

doi:10.1016/s0720-048x(02)00370-4

Cited by 96 publications

(77 citation statements)

References 12 publications

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“…1,[15][16][17][18][19][20][23][24][25][26][27][28] Additionally, also in common with other authors, 20,21 we did not observe superior patency in angioplasties with stents. Notwithstanding, our results differ with …”

Section: Discussionsupporting

confidence: 84%

“…Patency can vary from 72 to 100% at 3 months, through 55 to 100% at 6 months to 56 to 97% at 12 months. 20,[23][24][25][26][27][28] To our knowledge, to date there have been no prospective controlled studies comparing angioplasties with and without stents for treatment of COVD. In a retrospective study published by Bakken et al in 2007 20 and comparing angioplasties with and without stents, the authors showed that there were no significant differences in patency results between angioplasties with and without stents ( Table 3).…”

Section: Discussionmentioning

confidence: 99%

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Endovascular treatment of occlusive central venous disease: one center's experience

Silvestre¹,

Trevisan²,

Sardinha³

et al. 2014

J. vasc. bras.

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Introduction: The majority of cases of stenosis or occlusion of central veins are the result of central catheters, arteriovenous fistulas, neoplasms or traumas and these conditions can cause severe cases of venous hypertension or reduce the flow through fistulas. The objective of this study is to analyze the results of central venous angioplasties conducted at our hospital. Methodology: We conducted a retrospective and descriptive study to analyze the results of central venous angioplasties conducted from 2010 to 2012 at a university hospital run by the Universidade Estadual de Londrina, Brazil. We calculated primary and secondary success rates and analyzed whether or not stents were used and complications occurred during a 6-month follow-up period. Results: A total of 25 central venous angioplasties were conducted. Twenty-four (96%) of these were because of catheter-related intimal hyperplasia and one was to treat the effects of compression by a tumor. Fifteen (60%) angioplasties were to correct stenosis and ten (40%) were because of occlusions, with a one-hundred percent success rate for all stenosis-related procedures. However, none of the cases of occlusion could be treated endovascularly. Patency during the 6-months follow-up period was 80% after reinterventions. Conclusions: Despite good results observed after primary interventions for stenoses, it must be accepted that all current treatment options for chronic occlusive venous disease will, sooner or later, lead to restenosis or occlusion. Venous occlusions constitute a challenge demanding the development of new techniques and new materials. Prevention is paramount, through avoidance of central catheterization and early creation of arteriovenous fistulas.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of occlusive central venous disease: one center's experience

Silvestre¹,

Trevisan²,

Sardinha³

et al. 2014

J. vasc. bras.

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“…Indeed, the Society of Interventional Radiology (SIR) guidelines have indicated stent placement for central vein lesions (30). Some investigators have even argued that central venous lesions represent a primary indication for stent placement due to the poor outcome usually found with balloon dilation alone (18,31). The work of Gerald Beathard supports this assertion (32).…”

Section: Stents and Central Venous Stenosismentioning

confidence: 99%

“…Nineteen cases (26%) necessitated additional stent placement. Aytekin et al (18) evaluated the efficacy of stent placement for treating upper extremity CVS in 14 hemodialysis patients. The 1, 3, 6, and 12 mo primary patency rates were 92.8%, 85.7%, 50%, and 14.3%.…”

Section: Stents and Central Venous Stenosismentioning

confidence: 99%

Stent Placement in Hemodialysis Access

Yevzlin

Asif

2009

Clinical Journal of the American Society of Nephrology

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Vascular access stenosis in patients undergoing chronic hemodialysis is a major issue that is associated with increased morbidity, mortality, and cost of medical care. Recent data have emphasized that endovascular stents could be used in the treatment of central as well as peripheral stenotic lesions. In general, a peripheral or central vein lesion that is elastic or recurs within a three-month period after an initially successful balloon angioplasty or a stenosis where surgical revision is not possible are some indications for intravascular stent placement. Recent reports have expanded the role of stents in the management of pseudoaneurysms associated with dialysis access. In this context, the utilization of these devices must take into account a fair comparison with the traditional (surgical) approaches regarding effectiveness as well as costs. This report describes the role of stents in arteriovenous dialysis access. In addition, some of the recent advances in the structure and complicating issues such as stent fracture, migration, and infection, as well cannulation through the stent, are discussed.

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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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Endovascular stent placement in the treatment of upper extremity central venous obstruction in hemodialysis patients

Cited by 96 publications

References 12 publications

Endovascular treatment of occlusive central venous disease: one center's experience

Endovascular treatment of occlusive central venous disease: one center's experience

Stent Placement in Hemodialysis Access

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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