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Murine Model of Central Venous Stenosis using Aortocaval Fistula with an Outflow Stenosis
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Murine Model of Central Venous Stenosis using Aortocaval Fistula with an Outflow Stenosis

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Management of Central Venous Stenosis and Occlusion in Dialysis Patients

David M Tabriz1, Bulent Arslan1

  • 1Department of Vascular and Interventional Radiology, Rush University Medical Center, Chicago, Illinois.

Seminars in Interventional Radiology
|February 25, 2022
PubMed

Insights

Central venous occlusions (CVOs) in hemodialysis patients cause serious symptoms and limit access options. Endovascular recanalization is now the preferred treatment for appropriate cases.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Central venous occlusions (CVOs) affect major intrathoracic veins.
  • CVOs can lead to debilitating symptoms in end-stage kidney disease (ESKD) patients on hemodialysis (HD).
  • These occlusions negatively impact arteriovenous fistula/graft function and limit future access creation.

Purpose of the Study:

  • To review the incidence, pathophysiology, and management of CVOs in ESKD patients on HD.
  • To discuss indications and contraindications for CVO management.
  • To provide considerations and examples for planning endovascular central recanalization procedures.

Main Methods:

  • Literature review summarizing current knowledge on CVOs in ESKD on HD.
  • Analysis of incidence, pathophysiology, and management strategies.
  • Focus on endovascular recanalization techniques.

Main Results:

  • CVOs are a significant complication in ESKD patients undergoing HD.
  • Management options range from conservative to interventional.
  • Endovascular recanalization is increasingly the first-line approach when suitable.

Conclusions:

  • CVOs pose a substantial challenge for vascular access in ESKD patients on HD.
  • A thorough understanding of CVOs is crucial for effective patient management.
  • Endovascular recanalization offers a promising solution for selected patients, improving outcomes and preserving access options.

Keywords:
central venous stenosishemodialysisinterventional radiologyrecanalizationsuperior vena cava

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