Document Detail


Central venous stenosis in the hemodialysis patient: incidence and efficacy of endovascular treatment.
MedLine Citation:
PMID:  9464608     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Central venous stenosis occurs as a complication of central venous catheterization and significantly complicates delivery of dialysis through arteriovenous grafts in the ipsilateral upper limb. This report includes two separate studies. Functioning expanded polytetrafluorethylene grafts have been prospectively evaluated using duplex scanning and angiography performed in all patients with stenoses > 50%. From this, it has been prospectively established that the incidence of unsuspected central venous stenoses in patients with functioning grafts is 29%. In the second part of the report, the authors' experience in the treatment of 25 central venous stenoses with percutaneous angioplasty and stent placement has been retrospectively reviewed. Initial technical success rate was 88%. Primary patency was 84% at 1 month, 42% at 6 months, and 17% at 1 year. Mean primary patency was 5.7 months. Stents were placed in five patients. Prevention of central venous stenosis by avoiding subclavian catheterization is optimal. Balloon angioplasty provides short-term patency, but it is the only option in most cases. The role for endovascular stent placement remains to be defined but early results are not optimistic.
Authors:
A B Lumsden; M J MacDonald; H Isiklar; L G Martin; D Kikeri; L A Harker; R C Allen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiovascular surgery (London, England)     Volume:  5     ISSN:  0967-2109     ISO Abbreviation:  Cardiovasc Surg     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1998-03-20     Completed Date:  1998-03-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9308765     Medline TA:  Cardiovasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  504-9     Citation Subset:  IM    
Affiliation:
Department of Surgery, Emory University School of Medicine and the Veterans Affairs Medical Center, Atlanta, Georgia, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon
Arteriovenous Shunt, Surgical*
Blood Vessel Prosthesis
Catheterization, Central Venous
Female
Graft Occlusion, Vascular / epidemiology*,  therapy*
Humans
Incidence
Male
Middle Aged
Polytetrafluoroethylene
Prospective Studies
Renal Dialysis*
Retrospective Studies
Stents
Subclavian Vein*
Chemical
Reg. No./Substance:
9002-84-0/Polytetrafluoroethylene

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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