Abstract
Purpose: To determine the effectiveness of using Dacron-covered stents to treat access-related venous stenoses and occlusions.
Methods: Twenty-two Dacron-covered stents were placed in 20 patients: in the basilic or axillary vein (n=2), cephalic vein (n=3), subclavian vein (n=5), and at the venous anastomosis of the polytetrafluoroethylene (PTFE) implant graft (n=10).
Results: Initial technical success was 100%. The cumulative primary and secondary patency rates were 57% and 83% at 6 months, 29% and 64% at 12 months, and 29% and 53% at 18 months. A statistically significant difference in the stent patency was revealed by comparing the patients with stents in the subclavian vein and patients with upper arm stents. The secondary patency rates of the upper arm stents were 73% after 6, 12, and 18 months.
Conclusions: Percutaneous placement of Dacron-covered stents is a safe and effective procedure for salvage of a dialysis fistula. First results are promising, with a tendency to prolongation of the time interval between reinterventions.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Gmelin E, Karnel F (1990) Radiologische Rekanalisation von Venen, Gefässprothesen und Arterien bei insuffizienten Dialysefisteln. Fortschr Rontgenstr 153:432–437
Schwab S, Raymond J, Saeed M, Newman G, Dennis P, Bollinger R (1989) Prevention of hemodialysis fistula thrombosis: Early detection of venous stenoses. Kidney Int 36:707–711
Beathard G (1992) Percutaneous transvenous angioplasty in the treatment of vascular access stenosis. Kidney Int 42:1390–1397
Hood DB, Yellin AE, Richman MF, Weaver FA, Katz MD (1994) Hemodialysis graft salvage with endoluminal stents. Am Surg 60:733–737
Zollikofer CL, Antonucci F, Stuckmann G, Mattias P, Brühlmann WF, Salomonowitz EK (1992) Use of the Wallstent in the venous system including hemodialysis-related stenoses. Cardiovasc Intervent Radiol 15:334–341
Turmel-Rodrigues LA, Pengloan J, Blanchier D, Abaza M, Birmele B, Haillot O, Blanchard D (1993) Insufficient dialysis shunts: Improved long-term patency rates with close hemodynamic monitoring, repeated percutaneous balloon angioplasty, and stent placement. Radiology 187:273–278
Vorwerk D, Guenther RW, Mann H, Bohndorf K, Keulers P, Alzen G, Sohn M, Kistler D (1995) Venous stenosis and occlusion in hemodialysis shunts: Follow-up results of stent placement in 65 patients. Radiology 195:140–146
Turmel-Rodrigues LA, Blanchard D, Pengloan J, Sapoval M, Baudin S, Testou D, Mouton A, Abaza M (1997) Wallstents and Cragg stents in hemodialysis grafts and fistulas: Results for selective indications. J Vasc Interv Radiol 8:975–982
Surratt RS, Picus D, Hicks ME, Darcy MD, Kleinhoffer M, Jendrisak M (1991) The importance of preoperative evaluation of the subclavian vein in dialysis access planning. AJR 156:623–625
Quinn SF, Schuman ES, Hall L, Gross GF, Uchida BT, Standage BA, Rösch J, Ivancev K (1992) Venous stenoses in patients who undergo hemodialysis: Treatment with self-expandable endovascular stents. Radiology 183:499–504
Sullivan KL, Besarab A, Bonn J, Shapiro MJ, Gardiner GA Jr, Moritz MJ (1993) Hemodynamics of failing dialysis grafts. Radiology 186:867–872
Cragg AH, Dake MD (1997) Treatment of peripheral vascular disease with stent-grafts. Radiology 205:307–314
Gray RJ, Horton KM, Dolmatch BL, Rundback JH, Anaise D, Aquino AO, Currier CB, Light JA, Sasaki TM (1994) Use of Wallstents for hemodialysis access-related venous stenoses and occlusions untreatable with balloon angioplasty. Radiology 195:479–484
Vesely TM, Hovsepian DM, Pilgram TK, Coyne DW, Shenoy S (1997) Upper extremity central venous obstruction in hemodialysis patients: Treatment with Wallstents. Radiology 204:343–348
Sapoval MR, Turmel-Rodrigues LA, Raynaud AC, Bourquelot P, Rodrigue H, Gaux JC (1996) Cragg covered stents in hemodialysis access: Initial and midterm results. J Vasc Interv Radiol 7:335–342
Dake MD, Semba CP, Kee ST, Razavi MK, Slonim SM, Samuels SL, Sze DY (1998) Early results of Hemobahn for the treatment of peripheral arterial disease. In: Henry M, Amor M (eds) Ninth international course book of peripheral vascular intervention. Paris, Europa Edition, pp 260
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Farber, A., Barbey, MM., Grunert, JH. et al. Access-Related venous stenoses and occlusions: Treatment with percutaneous transluminal angioplasty and dacron-covered stents. Cardiovasc Intervent Radiol 22, 214–218 (1999). https://doi.org/10.1007/s002709900369
Issue Date:
DOI: https://doi.org/10.1007/s002709900369