Stent Grafts Provided Superior Primary Patency for Central Venous Stenosis Treatment in Comparison with Angioplasty and Bare Metal Stent: A Retrospective Single Center Study on 70 Hemodialysis Patients

Quaretti, Pietro; Galli, F.; Moramarco, Lorenzo Paolo; Corti, Riccardo; Leati, Giovanni; Fiorina, Ilaria; Tinelli, Carmine; Montagna, G.; Maestri, Marcello

doi:10.1177/1538574416639149

Cited by 40 publications

(29 citation statements)

References 33 publications

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“…If symptoms are present, PTA is performed; however, patency is poor, so repeat procedures are often required. Therefore, in many cases, the stent or SG is inserted later [18]. Because the diameter of the CV is larger than that of the peripheral vein, balloon dilatation may not efficiently dilate and correct the lesion.…”

Section: Treatmentmentioning

confidence: 99%

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Central venous disease in hemodialysis patients

Park

Choi

Baik

2019

Kidney Res Clin Pract.

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Central venous disease (CVD) is difficult to treat and often resistant to treatment. In CVD, hemodialysis vascular access should sometimes be abandoned, or in serious cases, the patient's life may be threatened. Therefore, prevention is ideal. However, as the prevalence of chronic kidney disease (CKD) has increased steadily with population aging, CKD patients with a peripherally inserted central catheter (PICC) are encountered frequently. PICCs can cause CVD, and the basilic vein, which is regarded as the important last option for native arteriovenous fistula (AVF) creation in end-stage renal disease (ESRD) patients, is destroyed frequently after its use as the entry site of PICC. The most well-established risk factors for CVD are a history of central venous catheter (CVC) insertion and its duration of use. Therefore, to reduce the incidence of CVD, catheterization in the central vein (CV) should be minimized, along with its duration of use. In this review, we will first explain the basic territories of the CV and introduce its pathophysiology, clinical features, and advanced treatment options. Finally, we will emphasize prevention of CVD.

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Section: Treatmentmentioning

confidence: 99%

“…In particular, in CVD, SG use showed favorable patency compared with PTA in several retrospective studies, although no prospective studies have been published yet. Table 1 shows a summary of the studies on SG use in HD CVD [3,18,22,25,26].…”

Section: Treatmentmentioning

confidence: 99%

Central venous disease in hemodialysis patients

Park

Choi

Baik

2019

Kidney Res Clin Pract.

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“…Primary stenting for central venous lesions is controversial. Improved primary patency rates and less frequent need for secondary procedures compared with venoplasty alone have been reported 22 ) ; however, there are conflicting studies reporting no significant difference in primary patency. 5 , 23 ) There are observational studies in the literature describing the use of stenting in lesions which are resistant to central venoplasty which report encouraging patency rates; however these do not include any comparative data.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Central Venoplasty in Haemodialysis Patients

Cuthbert

Kwan

et al. 2018

Annals of Vascular Diseases

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Objective: To review the outcomes of central venoplasty in the treatment of symptomatic central vein stenosis in patients undergoing haemodialysis via an ipsilateral arteriovenous fistula (AVF).Methods: Data were collected retrospectively, and included all the consecutive cases of central venoplasty between January 2008 and December 2015.Results: A total of 132 central venoplasties in 76 patients were performed, with incidence of symptomatic central vein stenosis at 7.4%. Of the patients, 66% were male and the mean age was 61 years. The most frequent indication was decreased dialysis access flow rates (58%) and 52% of all the patients had symptoms of upper limb swelling. The patients who had previous ipsilateral tunneled internal jugular vein dialysis catheters made up 58% of the patients. The mean time from AVF creation to first central venoplasty was 24 months, and 74% of the cases required a second central venoplasty and the mean time to second venoplasty was 7 months. The overall post intervention assisted primary patency rate was 87%, 74%, 63%, and 42% at 6, 12, 18, and 24 months respectively. Statistically significant differences were found in primary assisted patency (p=0.025) and time to second procedure (p=0.039) comparing those with and without a history of ipsilateral tunneled dialysis catheter.Conclusion: Central venoplasty is technically feasible with low procedural risk. The maintenance of the AVF patency usually requires multiple procedures at average interval of 7 months. Patients with a history of upper limb tunneled dialysis catheter ipsilateral to the side of central vein stenosis or AVF have a less favorable outcome compared to those without.

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“…Prophylactic antibiotic (Cefotaxime, 2 g IV) was administered. Digital Venography was done to know the exact location, length, and severity of CVSO (6,7) . The puncture site was achieved by ante grade puncture of the efferent vein above the elbow and away 5cm from the (AVF) anastomosis.…”

Section: Methodsmentioning

confidence: 99%

“…Fortunately, this was achieved by two or three inflations of 2-3 min for each one. When the balloon was not fully expanded even with high pressure, two or three more dilatations were tried, in our study we used (Boston scientific, Mustang™ PTA high pressure XXL Balloon Dilatation Catheter) (7) .…”

Section: Methodsmentioning

confidence: 99%