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Endovascular intervention for central venous cannulation in patients with vascular occlusion after previous

Andreas Pikwer1, Stefan Acosta, Tilo Kölbel

  • 1Department of Anesthesiology and Intensive Care Medicine, Lund University, Skåne University Hospital, Malmö, Sweden. andreas.pikwer@med.lu.se

The Journal of Vascular Access
|October 19, 2010
PubMed

Insights

Endovascular intervention effectively manages central venous occlusion in patients with a history of multiple catheterizations, particularly those undergoing hemodialysis. This approach is recommended for patients needing central venous access with confirmed occlusions.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Nephrology

Background:

  • Central venous occlusion (CVO) is a significant complication of repeated catheterizations.
  • Patients requiring long-term central venous access, especially for hemodialysis, are at higher risk.
  • CVO can impede future access and treatment options.

Purpose of the Study:

  • To evaluate the efficacy of endovascular intervention for treating central venous occlusion.
  • To assess outcomes in patients with CVO following previous catheterizations.
  • To identify patient characteristics associated with CVO.

Main Methods:

  • Retrospective analysis of a regional endovascular database.
  • Inclusion of 16 patients with CVO referred for endovascular management over 42 months.
  • Review of patient records, angiograms, and radiographic reports, including CT and MRT venography.

Main Results:

  • The study included 16 patients (11 female, median age 48) with a history of multiple central venous catheterizations.
  • Hemodialysis patients had fewer catheters inserted pre-intervention compared to nutritional support patients.
  • Various endovascular techniques were employed, including recanalization, angioplasty, and stenting, or cannulation via alternative routes.

Conclusions:

  • Central venous occlusion is prevalent in hemodialysis patients with extensive catheter use.
  • Endovascular intervention is a viable option for patients with CVO needing central venous access.
  • CT or MRT venography can verify CVO, guiding referral for endovascular treatment.
Abstract

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