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Metallic stenting for treatment of central venous obstruction in hemodialysis patients

Chiung-Yu Chen1, Huei-Lung Liang, Huay-Ban Pan

  • 1Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.

Journal of the Chinese Medical Association : JCMA
|June 5, 2003
PubMed

Insights

Primary Wallstent placement offers a safe and technically successful option for treating central venous obstructions in hemodialysis patients. While it provides extended access, repeated interventions may be needed to maintain patency.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Nephrology

Background:

  • Central venous obstruction is a frequent and severe complication in patients undergoing hemodialysis.
  • Recurrence rates are high after balloon dilation, and surgical repair poses significant risks for these patients.

Purpose of the Study:

  • To assess the efficacy of primary Wallstent placement in managing hemodialysis-related central venous obstructions.

Main Methods:

  • Eighteen hemodialysis patients with symptomatic central venous obstructions underwent primary Wallstent placement.
  • Technical success, complications, and patency rates (primary and secondary) were evaluated using survival analysis.

Main Results:

  • 100% technical success was achieved with Wallstent deployment in 18 patients (25 stents).
  • Re-obstruction occurred in 14 instances, managed with angioplasty or additional stenting; no stent migration was observed.
  • Primary patency rates at 18 months were 16% for the stent and 0% for access, while secondary patency rates at 24 months reached 68-72%.

Conclusions:

  • Wallstents are safe and achieve high technical success for hemodialysis-related central venous obstructions.
  • Wallstent placement ensures prolonged hemodialysis access, though repeat interventions may be required.
  • This approach offers a viable solution for managing complex venous obstructions in hemodialysis patients.
Abstract

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