Serial cardiac influence of volume overload induced by interventional therapy for central venous stenosis or occlusion in chronic hemodialysis patients

Horita, Yuki; Namura, Masanobu; Ikeda, Masatoshi; Tsuchiya, Taketsugu; Terai, Hidenobu; Fukuoka, Ryota; Takahashi, Naoto; Takagi, Toshimitsu; Kumatani, Yuji; Ishimori, Yasuhiro

doi:10.1016/j.jjcc.2011.01.004

Cited by 8 publications

(8 citation statements)

References 18 publications

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“…Accordingly, we should be mindful that PTA is contraindicated for such venous lesions if it is likely to cause complications, especially life-threatening events. 10–13 Interventionists who perform PTA for central venous lesions should thoroughly understand the indications and contraindications and should also be familiar with effective countermeasures for complications that may arise during intervention.…”

Section: Resultsmentioning

confidence: 99%

Percutaneous transluminal angioplasty for central venous stenosis or occlusion in hemodialysis patients

Horita

2018

J Vasc Access

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The objectives of central venous percutaneous transluminal angioplasty are to dilate the venous lesion and to extend the life of arteriovenous fistula for hemodialysis. It is reasonable to perform percutaneous transluminal angioplasty for central venous lesions if this interventional therapy is required to maintain stable dialysis therapy. However, the presence of large fresh thrombus at central venous lesion site represents a contraindication to percutaneous transluminal angioplasty unless the thrombus can first be removed by thrombectomy. Balloon angioplasty is a basic treatment for central venous lesion, but stent implantation is sometimes required. The self-expandable or balloon-expandable stent is chosen by the lesion location and characteristics. The lesion in subclavian vein is generally treated by self-expandable stent and right brachiocephalic vein is treated by balloon-expandable stent. The organic lesion of innominate vein with plaque is treated by self-expandable stent. Note that the innominate venous stenosis is sometimes caused by compression between the right brachiocephalic artery and the sternum, and this lesion is treated by balloon-expandable stent because the radial force of balloon-expandable stent is stronger than self-expandable stent. It is important to understand the indication and stent selection for central venous percutaneous transluminal angioplasty.

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Section: Resultsmentioning

confidence: 99%

Percutaneous transluminal angioplasty for central venous stenosis or occlusion in hemodialysis patients

Horita

2018

J Vasc Access

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“…If CVC dysfunction occurred repeatedly, pericatheter sleeve and CVS should be considered and detected by venogram. CVS should be suspected in patients with facial swelling and/or unilateral upper limb edema, collateral formation, and then it should be detected by venogram [4,12].…”

Section: Discussionmentioning

confidence: 99%

“…Most literatures [4][5][6], including the K/DOQI guidelines [15], recommend PTA, with or without stent placement as the preferred treatment approach to symptomatic CVS. Treatment with PTA and/ or stents is beneficial in maintaining dialysis access circuit patency (including AVF, AVG and PHC) [5,13,14,[16][17][18] and alleviating swelling of the ipsilateral arm, breast, or face in the short term [19].…”

Section: Discussionmentioning

confidence: 99%

“…(1) Patients preparing for arteriovenous fistula (AVF) creation with ipsilateral CVC (temporary or permanent hemodialysis catheters-PHC) or with history of ipsilateral CVC and/or central venous operations (including peripherally inserted central catheters-PICC, pacemaker and defibrillator wires); (27 patients) (2) Patients awaiting insertion of permanent hemodialysis catheter (PHC); (60 patients) (3) Patients with dysfunctional CVC (temporary catheter or PHC) which failed to be restored by thrombolysis for 3 consecutive days or whose CVC dysfunction happened for 3 times in 6 months; (16 patients) and (4) Patients with facial or breast swelling and/or unilateral upper limb edema, collateral formation, and thus were suspected to have CVS (13 patients). Issue 2 • 1000141 Intern Med ISSN: 2165-8048 IME, an open access journal found in 2 patients who presented arm edema ipsilateral to functioning AVF.…”

Section: Patients At High Risk Of Cvs Enrolled In Conventional Venogrmentioning

confidence: 99%

“…As HD patients live longer, we are facing a growing number of patients with CVS. Endovascular intervention, such as percutaneous transluminal angioplasty (PTA) with or without stenting is now recommended as the initial intervention for HD patients with CVS [4][5][6]. But their recommendations did not cover economic factors and survival benefits.…”

Section: Introductionmentioning

confidence: 99%

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Should Endovascular Intervention be the First Choice to Treat Central Vein Stenosis in Hemodialysis Population?

HE¹

2012

Intern Med

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Purpose: To evaluate the clinical features and the survival benefits of Chinese hemodialysis (HD) patients with central vein stenosis (CVS) undergoing different treatments. Methods: From January 1, 2011 to Dec 31, 2012, 116 HD patients at high risk of CVS at our hospital had their bilateral central veins assessed by vascular ultrasound and conventional venography. We compared the clinical outcome of 24 non-treated asymptomatic, 17 non-treated symptomatic CVS and 6 treated symptomatic CVS. Treatment costs of CVS were recorded and patients' survival rates were estimated by Kaplan-Meier analysis. Results: Among 116 patients, 47 were diagnosed with CVS. The timespan between symptomatic presentation and the diagnosis of CVS was more than 10 months averagely. Compared with non-CVS patients, the duration of HD in CVS patients was longer (33.8 ± 14.5 vs 1.1 ± 0.7 months) and the rate of central venous catheter (CVC) insertion was higher (87.2% vs 14.5%). Only 6 patients tried to maintain vascular access by endovascular intervention, the cost for which was $5210 per person, much higher than other treatment options. While 30 patients refused endovascular intervention for fear of re-stenosis risk and high treatment costs, among whom 28 lost their initial vascular access. The 12-month survival rates were 87.8%, 60% and 80.3%, respectively. The 24-month survival rates were 48.8%, 60% and 42.8%, respectively. No significant difference was found among the three groups. Conclusions: Endovascular intervention may not be the first choice for HD patients with CVS, considering long term survival benefit and high treatment cost. Intern a l M e d ic ine-O p e n A cc ess

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Dilation and Stent Placement

Turmel-Rodrigues¹,

Beyssen

Renaud

2012

Diagnostic and Interventional Radiology of Arteriovenous Accesses for Hemodialysis

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Serial cardiac influence of volume overload induced by interventional therapy for central venous stenosis or occlusion in chronic hemodialysis patients

Cited by 8 publications

References 18 publications

Percutaneous transluminal angioplasty for central venous stenosis or occlusion in hemodialysis patients

Percutaneous transluminal angioplasty for central venous stenosis or occlusion in hemodialysis patients

Should Endovascular Intervention be the First Choice to Treat Central Vein Stenosis in Hemodialysis Population?

Dilation and Stent Placement

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