CardioVascular and Interventional Radiology

, Volume 32, Issue 2, pp 271–278

Percutaneous Treatment of Central Venous Stenosis in Hemodialysis Patients: Long-Term Outcomes

  • Young Chul Kim
  • Jong Yun Won
  • Sun Young Choi
  • Heung-kyu Ko
  • Kwang-Hun Lee
  • Do Yun Lee
  • Byung-Chul Kang
  • Seung-Jung Kim
Clinical Investigation

DOI: 10.1007/s00270-009-9511-0

Cite this article as:
Kim, Y.C., Won, J.Y., Choi, S.Y. et al. Cardiovasc Intervent Radiol (2009) 32: 271. doi:10.1007/s00270-009-9511-0

Abstract

The purpose of this study was to evaluate the long-term outcomes of endovascular treatment of central venous stenosis in patients with arteriovenous fistulas (AVFs) for hemodialysis. Five hundred sixty-three patients with AVFs who were referred for a fistulogram were enrolled in this study. Among them, 44 patients showed stenosis (n = 35) or occlusions (n = 9) in the central vein. For the initial treatment, 26 patients underwent percutaneous transluminal angioplasty (PTA) and 15 patients underwent stent placements. Periods between AVF formation and first intervention ranged from 3 to 144 months. Each patient was followed for 14 to 60 months. Procedures were successful in 41 of 44 patients (93.2%). Primary patency rates for PTA at 12 and 36 months were 52.1% and 20.0%, and assisted primary patency rates were 77.8% and 33.3%, respectively. Primary patency rates for stent at 12 and 36 months were 46.7% and 6.7%, and assisted primary patency rates were 60.0% and 20.0%, respectively. Fifteen of 26 patients with PTAs underwent repeated interventions because of restenosis. Fourteen of 15 patients with a stent underwent repeated interventions because of restenosis and combined migration (n = 1) and shortening (n = 6) of the first stent. There was no significant difference in patency between PTAs and stent placement (> 0.05). Average AVF patency duration was 61.8 months and average number of endovascular treatments was 2.12. In conclusion, endovascular treatments of central venous stenosis could lengthen the available period of AVFs. There was no significant difference in patency between PTAs and stent placement.

Keywords

Vein Angioplasty Stent Hemodialysis Fistula Endovascular 

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Young Chul Kim
    • 1
  • Jong Yun Won
    • 1
  • Sun Young Choi
    • 1
  • Heung-kyu Ko
    • 1
  • Kwang-Hun Lee
    • 1
  • Do Yun Lee
    • 1
  • Byung-Chul Kang
    • 2
  • Seung-Jung Kim
    • 3
  1. 1.Department of Radiology, Research Institute of Radiological ScienceYonsei University College of MedicineSeoulKorea
  2. 2.Department of Radiology, College of MedicineEwha Woman’s UniversitySeoulKorea
  3. 3.Department of Internal Medicine, College of MedicineEwha Woman’s UniversitySeoulKorea

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