Stenting of central venous stenoses and occlusions to maintain hemodialysis vascular access.

BACKGROUND/AIMS: The aim of the study was to evaluate the efficacy of stenting for the treatment of central arm vein obstructions in hemodialysis patients in order to maintain hemodialysis from the affected side.

METHODS

Fifteen self-expanding (8) and balloon expandable (7) stainless steel stents were implanted in 10 hemodialysis patients for the treatment of symptomatic central arm vein obstructions. Thirteen lesions were treated: 6 subclavian, 4 innominate and 3 restenoses.

RESULTS

Stent deployment was successful in all cases leading to resolution of symptoms by correcting the underlying cause of venous hypertension. Follow-up from 3 months to 4 years revealed four deaths from unrelated causes, three restenoses at 1, 3, 4 months and one occlusion at 6 months respectively for a cumulative primary one-year and two-year patency rate of 70%.

CONCLUSION

Stenting of subclavian and innominate venous stenoses and occlusions effectively corrected the underlying lesions responsible for disturbed hemodynamics and, in most cases, prolonged available hemodialysis access from the affected side.