[The radiologist and central venous stenosis]

Occurrence of a central venous stenosis or occlusion is a frequent and major complication of indwelling central venous catheters. Two mechanisms may explain such a complication: thrombosis and fibrosis causing progressive stenosis. When these central vein lesions are symptomatic or preclude the creation of an angio-access for hemodialysis, they should be treated. Then, the first choice treatment is interventional radiology. Thromboses are treated by anticoagulation, local fibrinolysis and angioplasty of the residual lesion. Stenoses and chronic occlusions are treated by angioplasty more or less stent implantation. These percutaneous treatments are very effective and incomparably simpler than surgery, which often requires thoracotomy. However, often, such a treatment should be renewed because of the occurrence of a restenosis. Theses central venous lesions should be feared and taken into account for indication of central venous catheter placement.