Percutaneous treatment of symptomatic central venous stenosis angioplasty

Abstract

Central venous occlusive disease has emerged as a significant clinical problem. Percutaneous venous angioplasty can provide temporary symptomatic relief; however, multiple procedures are often required and long-term relief is rarely achieved.

Effect of Central Venous Angioplasty on Hemodialysis Access Circuit Flow: Prospective Study of 25 Symptomatic Patients

“…CVS is common in patients undergoing hemodialysis (2,3,5,6,19). CVS can cause debilitating symptoms depending on the vessel(s) affected.…”

“…CVS can cause debilitating symptoms depending on the vessel(s) affected. Subclavian stenosis typically causes edema of the ipsilateral arm and/or breast, whereas brachiocephalic stenosis often causes ipsilateral neck or facial edema (3,5,6). Incidentally discovered asymptomatic CVS should not be treated because treating asymptomatic CVS can elicit more severe stenosis; only about 40% of asymptomatic CVSs worsen after 4 years (20)(21)(22).…”

“…Key risk factors for CVS are previous central venous catheter placement and transvenous rhythm devices (2)(3)(4)(5)(6). CVS can be located in any of the major intrathoracic (subclavian vein, brachiocephalic vein, and superior vena cava [SVC]) or intraabdominal (iliac veins and inferior vena cava [IVC]) veins draining the extremities, where permanent hemodialysis accesses are usually placed.…”

“…CVS can be located in any of the major intrathoracic (subclavian vein, brachiocephalic vein, and superior vena cava [SVC]) or intraabdominal (iliac veins and inferior vena cava [IVC]) veins draining the extremities, where permanent hemodialysis accesses are usually placed. Symptomatic CVS is primarily treated with percutaneous transluminal angioplasty (PTA) (2,3,(6)(7)(8)(9)(10).…”

Guidelines for basic techniques in vascular access intervention therapy (VAIVT)

“…Although there is some debate over indications, currently indications on which there is a relative amount of consensus are as follow 3,4,12,13,14,15,30,34,64,66,67,83,84 1. Cases of elastic recoil in which at least 30% of the stenosis remains regardless of the fact that full expansion of a balloon of appropriate diameter was possible.…”