Society of Interventional Radiology Reporting Standards for Thoracic Central Vein Obstruction: Endorsed by the American Society of Diagnostic and Interventional Nephrology (ASDIN), British Society of Interventional Radiology (BSIR), Canadian Interventional Radiology Association (CIRA), Heart Rhythm Society (HRS), Indian Society of Vascular and Interventional Radiology (ISVIR), Vascular Access Society of the Americas (VASA), and Vascular Access Society of Britain and Ireland (VASBI)

Dolmatch, Bart L.; Gurley, John C.; Baskin, Kevin M.; Nikolic, Boris; Lawson, Jeffrey H.; Shenoy, Surendra; Saad, Theodore F.; Davidson, Ingemar; Baerlocher, Mark O.; Cohen, E.; Dariushnia, Sean R.; Faintuch, Salomão; d’Othée, Bertrand Janne; Kinney, Thomas B.; Midia, Mehran; Clifton, James

doi:10.1177/1129729818791409

Cited by 27 publications

(32 citation statements)

References 67 publications

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“…According to the Society of Interventional Radiology classification, central veins include intrathoracic segments of internal jugular veins (IJVs), subclavian veins (SCVs), brachiocephalic veins (BCVs), and superior vena cava (SVC). 15 CVL diagnosis was made based on clinical and radiological data. Patients with debilitating symptoms of edema in the affiliated limb, breast, and face and with inadequate dialysis were included in our analysis.…”

Section: Lesion Characteristicsmentioning

confidence: 99%

<p>Lesion Type Analysis of Hemodialysis Patients Who Underwent Endovascular Management for Symptomatic Central Venous Disease</p>

Aljarrah¹,

Allouh²,

Hallak³

et al. 2020

VHRM

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Purpose: Central venous lesions (CVLs) can adversely affect hemodialysis access maturation and maintenance, which in turn worsen patient morbidity and access circuit patency. In this study, we assessed several clinical variables, patient characteristics, and clinical consequences of symptomatic central vein stenosis and obstruction in patients who underwent renal replacement therapy in the form of hemodialysis. Patients and Methods: The medical records of all hemodialysis patients with clinically symptomatic CVLs who underwent digital subtraction angiography treatment at King Abdullah University Hospital between January 2017 and December 2019 were retrieved. Patient characteristics and the clinical and anatomical features of CVLs were analyzed retrospectively. Pearson's chi-square tests of association were used to identify and assess relationships between patient characteristics and CVLs. Results: The study cohort comprised 66 patients with end-stage renal disease who developed symptomatic central vein stenosis. Of the 66 patients, 56.1% were men, and their mean age was approximately 52 years. Most (62.1%) of the patients were determined to have a history of central catheter insertion into the jugular vein. Hypertension was the most common comorbidity (78.8%, p<0.001), followed by type 2 diabetes mellitus (47.0 %, p<0.01). The incidence of stenosis was found to be significantly higher in the brachiocephalic vein than in other central veins (43.9%, p<0.001). A repeated central catheter insertion in a patient was predictive of central venous occlusion (p<0.05). Stenotic lesions were found to be associated with a significantly higher success rate than occlusive lesions (91.2%, p<0.01). Conclusion: Multiple central venous catheters (CVCs) are found to be associated with occlusive CVLs and unfavorable recanalization outcomes. Multiple CVC should be avoided by creating a permanent vascular access in a timely fashion for patients with chronic kidney disease and by avoiding the ipsilateral insertion of CVC and AVF.

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Section: Lesion Characteristicsmentioning

confidence: 99%

<p>Lesion Type Analysis of Hemodialysis Patients Who Underwent Endovascular Management for Symptomatic Central Venous Disease</p>

Aljarrah¹,

Allouh²,

Hallak³

et al. 2020

VHRM

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“…Die optimale Radialkraft eines Wallstents wird nur bei einer kom-pletten Entfaltung und einer vollen Wandapposition des Stents erreicht [40], was lediglich bei einem Teil der Patienten gelingt. Die Radialkraft eines unfixierten Wallstents beträgt lediglich 1 1 ⁄3 3 des maximal erreichbaren, optimalen Wertes [40].…”

Section: Klinische Präsentation Und Diagnostikunclassified

“…Die thorakalen zentralen Venen projizieren sich medial des Außenrands der 1. Rippe, kranial oberhalb des Zwerchfellschattens und kaudal der oberen Thoraxapertur (Höhe von HWK VII -BWK I) [1]. Die ebenfalls intrathorakal verlaufende V. azygos wird dagegen, neben den oberflächlichen, paraspinalen, epiduralen sowie Thoraxwandvenen, nicht zu den zentralen Venen gerechnet.…”

Section: Introductionunclassified

Thorakale zentralvenöse Obstruktionen und arteriovenöser Zugang

Burbelko

2020

Zentralbl Chir

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ZusammenfassungBenigne zentralvenöse thorakale Obstruktionen haben bei Hämodialysepatienten eine hohe Prävalenz. Die symptomatischen Stenosen führen zur Verschlechterung der Lebensqualität sowie zu Dysfunktionen der arteriovenösen Dialysezugänge bis hin zum Verschluss. Auch eine Implantation eines zentralvenösen Katheters kann dadurch erschwert oder unmöglich gemacht werden. Zu den Risikofaktoren zählen in erster Linie ein Vorhandensein oder eine Vorgeschichte eines zentralvenösen Katheters oder einer Schrittmachersonde. Die Diagnose kann meistens aufgrund der typischen Symptomatik vermutet werden, die digitale Subtraktionsangiografie bleibt als bildgebende Methode der Goldstandard der Diagnostik. Asymptomatische Patienten profitieren nicht von einer prophylaktischen Behandlung, diese kann oft zur raschen morphologischen und klinischen Progredienz der Stenose führen. Endovaskuläre Techniken stellen die primäre Therapieoption dar, die chirurgischen Maßnahmen sind Patienten ohne endovaskuläre Therapieoptionen vorbehalten. Die Standardtherapie ist die repetitive perkutane Ballonangioplastie. Eine Insertion eines nicht ummantelten Metallstents kann bei einem elastischen Recoiling bzw. bei einem Frührezidiv sinnvoll sein. Ein Einsatz eines Stentgrafts sollte in selektierten Fällen abgewogen werden. Der Stellenwert der neuen Techniken, wie die Anwendung dedizierter venöser Stents bzw. medikamentenbeschichteter Ballons, sollte im Rahmen von randomisierten Studien geprüft werden.

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“…The true incidence of DVT and stenosis in patients who require chronic access is unknown because most studies are limited to symptomatic patients and reporting has been largely nonstandardized . However, asymptomatic thrombosis has clearly been demonstrated in children with CVCs with serious consequences including loss of venous access, infection, pulmonary embolic disease, and post‐thrombotic syndrome .…”

Section: Failure Points and Essential Components Of Carementioning

confidence: 99%

“…A similar framework can be used to document the location, extent, and nature of venous salvage procedures and other interventions, such as adherent catheter retrieval, catheter tip repositioning, recanalization, venoplasty, and stent insertion. As data accumulate on the relationship between patterns of venous injury, obstruction, and other critical endpoints, disease‐specific analysis may prove increasingly useful …”

Section: Failure Points and Essential Components Of Carementioning

confidence: 99%

Evidence‐Based Strategies and Recommendations for Preservation of Central Venous Access in Children

Baskin

Mermel

Saad

et al. 2019

J Parenter Enteral Nutr

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Children with chronic illness often require prolonged or repeated venous access. They remain at high risk for venous catheter–related complications (high‐risk patients), which largely derive from elective decisions during catheter insertion and continuing care. These complications result in progressive loss of the venous capital (patent and compliant venous pathways) necessary for delivery of life‐preserving therapies. A nonstandardized, episodic, isolated approach to venous care in these high‐need, high‐cost patients is too often the norm, imposing a disproportionate burden on affected persons and escalating costs. This state‐of‐the‐art review identifies known failure points in the current systems of venous care, details the elements of an individualized plan of care, and emphasizes a patient‐centered, multidisciplinary, collaborative, and evidence‐based approach to care in these vulnerable populations. These guidelines are intended to enable every practitioner in every practice to deliver better care and better outcomes to these patients through awareness of critical issues, anticipatory attention to meaningful components of care, and appropriate consultation or referral when necessary.*

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Cited by 27 publications

References 67 publications

<p>Lesion Type Analysis of Hemodialysis Patients Who Underwent Endovascular Management for Symptomatic Central Venous Disease</p>

<p>Lesion Type Analysis of Hemodialysis Patients Who Underwent Endovascular Management for Symptomatic Central Venous Disease</p>

Thorakale zentralvenöse Obstruktionen und arteriovenöser Zugang

Evidence‐Based Strategies and Recommendations for Preservation of Central Venous Access in Children

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