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Mid-Term Outcomes of Patients with Central Venous Occlusive Disease Undergoing Surveillance Venography and

Hui Lin Wong1, Shaun Xavier Jm Chan, Satheesh Ramamuthy

  • 1Department of Vascular and Interventional Radiology, Singapore General Hospital, Singapore.

Annals of the Academy of Medicine, Singapore
|July 27, 2020
PubMed

Insights

Regular surveillance venography with percutaneous transluminal angioplasty (PTA) can achieve high patency rates in haemodialysis patients with central venous occlusive disease (CVOD). However, central venous occlusions (CVOs) are more challenging to treat than central venous stenosis (CVS).

Area of Science:

  • Vascular Surgery
  • Nephrology
  • Interventional Radiology

Background:

  • Central venous occlusive disease (CVOD) is a significant complication in haemodialysis patients.
  • Management strategies for CVOD, including surveillance venography and percutaneous transluminal angioplasty (PTA), require evaluation.

Purpose of the Study:

  • To assess the mid-term outcomes of surveillance venography with or without PTA in haemodialysis patients with CVOD.
  • To compare outcomes between central venous occlusion (CVO) and central venous stenosis (CVS).

Main Methods:

  • Retrospective analysis of 77 patients with central venous stenosis (CVS) and 35 patients with central venous occlusion (CVO) between 2008-2011.
  • Patients underwent PTA for significant stenosis (>50%) or occlusion (100%) and were followed with surveillance venography every 3-6 months.
  • Technical success, primary patency, and primary assisted patency were analyzed.

Main Results:

  • Technical success rates for initial PTA were 77% for CVO and 73% for CVS.
  • Primary assisted patency at 1 year was 88% for CVO and 99% for CVS (P=0.009).
  • Overall primary assisted patency showed a significant difference between CVO and CVS groups (P=0.048).

Conclusions:

  • Central venous occlusions (CVOs) present greater treatment challenges than central venous stenosis (CVS).
  • Surveillance venography, coupled with repeat interventions, can yield high primary assisted patency rates.
  • Further cost-effectiveness studies are warranted to determine the full benefit of surveillance programs.
Abstract

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