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Long-term results of stent-graft placement to treat central venous stenosis and occlusion in hemodialysis patients with arteriovenous fistulas
- Source :
- Journal of vascular and interventional radiology : JVIR. 22(9)
- Publication Year :
- 2010
-
Abstract
- Purpose To determine the effectiveness of stent-grafts for the treatment of central venous disease in hemodialysis patients with functioning arteriovenous (AV) fistulas. Materials and Methods Between October 2004 and March 2010, 42 VIABAHN stent-grafts were deployed in central veins of 30 patients (16 men, 14 women; mean age 60 y) with functioning AV fistulas and central venous disease that did not respond to percutaneous transluminal angioplasty (PTA). Eighteen patients had central vein stenosis and 12 had occlusion. Previous PTA and/or bare metal stent placement had been performed in 23 patients (77%). Surveillance was carried out at 3, 6, 9, 12, 18, and 24 months with diagnostic fistulography. The mean follow-up was 705 days (range, 66–1,645 d). Statistical analysis included Kaplan–Meier and log-rank studies. Results Technical success rate was 100%. Primary patency rates were 97%, 81%, 67%, and 45% at 3, 6, 12, and 24 months, respectively. Primary assisted patency rates were 100%, 100%, 80%, and 75% at 3, 6, 12, and 24 months, respectively. Patients without previous procedures had significantly shorter times to repeat intervention ( P = .018) than those who had undergone PTA or bare metal stent placement previously. Patients with occlusive lesions had a significantly shorter primary patency interval ( P = .05) than patients with stenoses. Occluded veins were more likely to require further stent-grafts ( P = .02). Twelve patients required further stent-grafts to maintain patency. There was one minor complication. Conclusions Stent-graft placement to treat central venous disease in hemodialysis patients with autogenous AV fistulas is safe and effective if PTA fails to maintain luminal patency.
- Subjects :
- Bare-metal stent
Adult
Male
medicine.medical_specialty
Catheterization, Central Venous
Time Factors
medicine.medical_treatment
Constriction, Pathologic
Kaplan-Meier Estimate
Prosthesis Design
Veins
Blood Vessel Prosthesis Implantation
Arteriovenous Shunt, Surgical
Blood vessel prosthesis
Renal Dialysis
Angioplasty
medicine
Vascular Patency
Humans
Radiology, Nuclear Medicine and imaging
Vascular Diseases
Vein
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Stent
Phlebography
Middle Aged
medicine.disease
Surgery
Blood Vessel Prosthesis
Stenosis
surgical procedures, operative
medicine.anatomical_structure
Treatment Outcome
England
Female
Stents
Radiology
Hemodialysis
Cardiology and Cardiovascular Medicine
business
Angioplasty, Balloon
Subjects
Details
- ISSN :
- 15357732
- Volume :
- 22
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Journal of vascular and interventional radiology : JVIR
- Accession number :
- edsair.doi.dedup.....25f7f8702f7b566a88a9ba71f85f3210