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Percutaneous treatment of central venous stenosis in hemodialysis patients: long-term outcomes

Authors
 Young Chul Kim  ;  Jong Yun Won  ;  Sun Young Choi  ;  Heung-kyu Ko  ;  Kwang-Hun Lee  ;  Do Yun Lee  ;  Byung-Chul Kang  ;  Seung-Jung Kim 
Citation
 CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, Vol.32(2) : 271-278, 2009 
Journal Title
 CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY 
ISSN
 0174-1551 
Issue Date
2009
MeSH
Arteriovenous Shunt, Surgical* ; Brachiocephalic Veins/diagnostic imaging ; Catheterization, Central Venous/adverse effects* ; Female ; Graft Occlusion, Vascular/diagnostic imaging ; Graft Occlusion, Vascular/etiology ; Graft Occlusion, Vascular/therapy* ; Humans ; Male ; Middle Aged ; Radiography, Interventional ; Renal Dialysis* ; Stents ; Subclavian Vein/diagnostic imaging ; Survival Rate ; Treatment Outcome ; Vascular Patency
Keywords
Vein ; Angioplasty ; Stent ; Hemodialysis ; Fistula ; Endovascular
Abstract
The purpose of this study was to evaluate the long-term outcomes of endovascular treatment of central venous stenosis in patients with arteriovenous fistulas (AVFs) for hemodialysis. Five hundred sixty-three patients with AVFs who were referred for a fistulogram were enrolled in this study. Among them, 44 patients showed stenosis (n = 35) or occlusions (n = 9) in the central vein. For the initial treatment, 26 patients underwent percutaneous transluminal angioplasty (PTA) and 15 patients underwent stent placements. Periods between AVF formation and first intervention ranged from 3 to 144 months. Each patient was followed for 14 to 60 months. Procedures were successful in 41 of 44 patients (93.2%). Primary patency rates for PTA at 12 and 36 months were 52.1% and 20.0%, and assisted primary patency rates were 77.8% and 33.3%, respectively. Primary patency rates for stent at 12 and 36 months were 46.7% and 6.7%, and assisted primary patency rates were 60.0% and 20.0%, respectively. Fifteen of 26 patients with PTAs underwent repeated interventions because of restenosis. Fourteen of 15 patients with a stent underwent repeated interventions because of restenosis and combined migration (n = 1) and shortening (n = 6) of the first stent. There was no significant difference in patency between PTAs and stent placement (p > 0.05). Average AVF patency duration was 61.8 months and average number of endovascular treatments was 2.12. In conclusion, endovascular treatments of central venous stenosis could lengthen the available period of AVFs. There was no significant difference in patency between PTAs and stent placement.
Full Text
http://link.springer.com/article/10.1007%2Fs00270-009-9511-0
DOI
10.1007/s00270-009-9511-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Ko, Heung Kyu(고흥규)
Kim, Young Chul(김영철)
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Kwang Hun(이광훈)
Lee, Do Yun(이도연)
Choi, Sun Young(최선영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104104
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