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Role of stents in hemodialysis vascular access

Kenneth Abreo1, Adrian Sequeira1

  • 1School of Medicine, LSU Health Shreveport, Shreveport, LA, USA.

The Journal of Vascular Access
|March 14, 2018
PubMed

Insights

Stents in hemodialysis access reduce interventions but do not improve survival. Covered nitinol stents are superior to bare metal stents, with stent grafts outperforming both.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Stents are crucial for managing stenosis in coronary and peripheral arteries.
  • In nephrology, stents are deployed in the venous outflow of arteriovenous access to treat stenosis.
  • Stenosis is a primary cause of access dysfunction and potential thrombosis in hemodialysis patients.

Purpose of the Study:

  • To review the indications for stent deployment in hemodialysis access.
  • To examine the current evidence supporting the use of stents in this context.
  • To discuss the complications associated with stent use in hemodialysis access.

Main Methods:

  • Review of current literature and randomized control trials.
  • Analysis of stent types, including bare metal stainless steel and covered nitinol stents.
  • Comparison of stent performance against angioplasty and stent grafts.

Main Results:

  • Stents decrease the frequency of interventions needed to maintain patency.
  • Overall access survival rates are not improved by stent deployment.
  • Bare metal stents are less effective than stent grafts.

Conclusions:

  • Stent deployment is indicated for stenosis in hemodialysis access.
  • While reducing re-interventions, stents do not enhance long-term access survival.
  • Stent grafts represent an advancement over traditional bare metal stents.

Keywords:
Stentsangioplastyhemodialysis vascular access

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