Use of the Viabahn stent graft for the treatment of recurrent cephalic arch stenosis in hemodialysis accesses

Miller, Gregg; Preddie, Dean C.; Savransky, Yevgeny; Spergel, Lawrence M.

doi:10.1016/j.jvs.2017.08.018

Cited by 38 publications

(54 citation statements)

References 24 publications

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“…Cephalic arch stenosis affects up to 34% of dysfunctional brachiocephalic AVFs (Bennett et al 2015). The use of stents, in particular SGs, to treat recurrent cephalic arch stenosis has been increasing due to low primary patency rates of balloon angioplasty and an increasing body of evidence demonstrating superior patency rates of stents (Miller et al 2018;D'Cruz et al 2019). Despite appropriate sizing and accurate deployment of the Fluency SG, central stent migration may result in jailing of the axillary vein.…”

Section: Discussionmentioning

confidence: 99%

“…Stent-graft (SG) placement for cephalic arch stenosis in dysfunctional dialysis access is an option for patients, and a recent systematic review suggests that it may be more durable in the short term compared to angioplasty alone (Miller et al 2018;D'Cruz et al 2019). Precise placement of SGs in the cephalic arch, particularly the terminal segment near or at the junction with the axillary vein, can be difficult.…”

Section: Introductionmentioning

confidence: 99%

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Recanalisation of an axillary vein occlusion jailed by a migrated cephalic arch stent-graft using the TruePath chronic total occlusion drilling device

2020

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Background: Stent placement in the cephalic arch is being used with increasing frequency. Late complications of bare metal and stent grafts in dialysis access, in particular stent migration, are often under-reported and can lead to compromise of future dialysis circuits. Case presentation: A 52-year-old man developed acute arm swelling 2 days after creation of a left arm brachiobasilic arteriovenous graft. The axillary vein was found to be jailed by a previously deployed cephalic arch stent graft which had migrated into the subclavian vein. There was failure to cross through the fabric of the stent graft using conventional chronic total occlusion wires and techniques. A TruePath device was used successfully to cross through the fabric of migrated cephalic arch stent graft and recanalise the short subclavian-axillary vein occlusion. Conclusion: The adapted use of a drilling chronic total occlusion device to drill through the fabric of migrated stent graft was performed successfully to allow complete recanalisation of the occluded axillary vein.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Recanalisation of an axillary vein occlusion jailed by a migrated cephalic arch stent-graft using the TruePath chronic total occlusion drilling device

2020

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“…Cephalic arch stenosis and occlusion are common in hemodialysis patients and are successfully treated with stent grafts with 60% primary patency and 98% secondary patency at 1 year (10). In 1 of the larger surgical studies, a comparison of 219 patients found that the 2-year patency was greater than 90% for cephalic vein transposition and bypass surgery and less successful, with 63% and 59% patency, for balloon dilation and bare metal stents (3).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Costoclavicular Bypass for Thoracic Outlet Syndrome and Cephalic Arch Occlusion in Hemodialysis Patients

Hull

Snyder

2019

Journal of Vascular and Interventional Radiology

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Purpose: To report results of percutaneous costoclavicular bypass for symptomatic thoracic outlet or cephalic arch occlusion in patients with arteriovenous fistula. Materials and Methods: A retrospective review of percutaneous costoclavicular bypass patients between 2014 and 2018 was performed. Stent grafts were placed subcutaneously over the clavicle from the fistula outflow (axillary or cephalic vein) into a jugular vein or collateral. The procedures were performed in patients who had exhausted or were not candidates for balloon dilation or intravascular stent placement. Results: Technical success was 100% (9/9) with resolution of symptoms in all patients. Indications were arm swelling in 67% (6/9), fistula dysfunction in 22% (2/7), and 1 enlarging aneurysm. The fistula outflow was cephalic in 67% (6/9) and axillary in 33% (3/9). The return vessel was external jugular in 78% (7/9) and internal jugular in 22% (2/9). Two overlapping Viabahn stent grafts were used in 88% of cases (7/8) and 3 stent grafts in 1 case. In the initial case, 2 Gore hybrid grafts were used. Stent graft diameter ranged from 9 mm to 13 mm. Mean follow-up was 852 ± 339 days (range, 488-1483 days). At 12 months and 24 months, primary patency was 67% and 67%, and secondary patency was 89% and 78%, respectively. Complications included late thrombosis and secondary infection. There were no anastomotic leaks or seromas associated with extravascular stent grafts. Conclusions: The percutaneous costoclavicular bypass is a feasible option for thoracic outlet and cephalic arch occlusion in symptomatic dialysis patients.

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“…Currently, the authors would likely use a self-expanding stent graft, such as a Viabahn (W. L. Gore, Flagstaff, AZ), which has the additional advantage of improved patency rates in the cephalic arch compared with angioplasty or bare metal stents. [7][8][9][10][11] Given the IFU warning against using the PTD in stents, case reports of stent-related complications are predictably difficult to find in the literature. Recent stent placement, poor wall apposition (more likely in fistulae than in grafts), and bare metal construction could all plausibly contribute to increased likelihood of stent entanglement with the fragmentation basket.…”

Section: Discussionmentioning

confidence: 99%

Managing Arrow-Trerotola Percutaneous Thrombolytic Device Complications

Simpson

Gaba

Lipnik

2019

Semin intervent Radiol

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Dialysis access interventions are frequently performed by interventional radiologists. Several commercially available percutaneous thrombolytic devices can help restore patency to thrombosed arteriovenous access circuits. The Arrow-Trerotola Percutaneous Thrombolytic Device is one such device, and has a long track record of safe and effective use. However, like any medical device, complications can occur during its use. This article describes three complications and associated management strategies utilizing fundamental interventional radiology techniques of balloon tamponade, stent placement, and snare mediated foreign body retrieval.

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Use of the Viabahn stent graft for the treatment of recurrent cephalic arch stenosis in hemodialysis accesses

Cited by 38 publications

References 24 publications

Recanalisation of an axillary vein occlusion jailed by a migrated cephalic arch stent-graft using the TruePath chronic total occlusion drilling device

Recanalisation of an axillary vein occlusion jailed by a migrated cephalic arch stent-graft using the TruePath chronic total occlusion drilling device

Percutaneous Costoclavicular Bypass for Thoracic Outlet Syndrome and Cephalic Arch Occlusion in Hemodialysis Patients

Managing Arrow-Trerotola Percutaneous Thrombolytic Device Complications

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