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Central venoplasty in AV (Arteriovenous) fistula dysfunction a palliative endovascular approach

Tariq Ashraf1, Naeem Mengal1, Naveed Ullah Khan1

  • 1Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Karachi.

JPMA. the Journal of the Pakistan Medical Association
|December 20, 2017
PubMed

Insights

Central venous stenosis, a complication of haemodialysis catheters in chronic kidney disease (CKD) patients, can impair dialysis. Successful venoplasty restored blood flow and dialysis function in two reported cases.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Chronic kidney disease (CKD) management often requires temporary haemodialysis via indwelling catheters.
  • Central venous catheters, including permacaths, are essential for haemodialysis but can lead to central venous stenosis.
  • Subclavian vein stenosis is a significant complication, compromising optimal dialysis access.

Observation:

  • Two patients with CKD requiring haemodialysis presented with arm pain and edema.
  • Diagnostic venography revealed complete occlusion of the right subclavian vein and left innominate vein.
  • These symptoms indicated severe central venous stenosis impacting dialysis access.

Findings:

  • Venoplasty was performed to address the central venous stenosis.
  • Post-procedure follow-up demonstrated successful restoration of blood flow.
  • The patients experienced normalization of arm swelling and regained optimal dialysis function via their AV fistula.

Implications:

  • Venoplasty is an effective treatment for central venous stenosis in haemodialysis patients.
  • Interventional techniques can salvage compromised dialysis access and improve patient outcomes.
  • Addressing central venous stenosis is crucial for maintaining effective haemodialysis in CKD patients.

Keywords:
Central Venous Stenosis, AV (Arteriovenous) Fistula and Venoplasty.

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