Gary Andrew Cuthbert1, Zhiwen Joseph Lo2, Justin Kwan3, Sadhana Chandrasekar2, Glenn Wei Long Tan2. 1. Leeds Vascular Institute, Leeds General Infirmary, Leeds, UK. 2. Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore. 3. Vascular and Intervention Radiology, Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore.
Abstract
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.
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.
Entities:
Keywords:
arteriovenous fistula; central venoplasty; haemodialysis; percutaneous angioplasty; renal access
Authors: Anthony G Verstandig; Daniel Berelowitz; Ibrahim Zaghal; Ilya Goldin; Oded Olsha; Bashar Shamieh; Vladimir Shraibman; David Shemesh Journal: J Vasc Interv Radiol Date: 2013-06-24 Impact factor: 3.464
Authors: Javier E Anaya-Ayala; Christopher J Smolock; Benjamin D Colvard; Joseph J Naoum; Jean Bismuth; Alan B Lumsden; Mark G Davies; Eric K Peden Journal: J Vasc Surg Date: 2011-06-12 Impact factor: 4.268