Use of the Viabahn stent graft for the treatment of recurrent cephalic arch stenosis in hemodialysis accesses.

Objective: Cephalic arch stenosis (CAS) is a frequent and challenging failure mode of brachiocephalic fistulas. Natural tortuosity of the cephalic arch requires special consideration in selecting a treatment modality. Typical percutaneous angioplasty and bare-metal stent (BMS) treatments provide a short-term treatment solution for CAS without a durable effect.

Sharp needle recanalization for salvaging hemodialysis accesses with chronically occluded peripheral outflow.

Purpose: To assess the effectiveness of sharp needle recanalization (SNR) for treatment of chronically occluded venous outflow in hemodialysis access.

Methods: A retrospective analysis of patient records from January 2006 to March 2010 was conducted. Forty-four hemodialysis patients (31 fistulas, 13 grafts) were referred for arm swelling (18%), excessive bleeding after dialysis (29%), and thrombosis (53%).

Percutaneous salvage of thrombosed immature arteriovenous fistulas.

Thrombosed immature fistulas have historically been considered unsalvageable. However, advances in procedure and balloon catheter technologies have expanded the scope of endovascular treatments. This study investigates the efficacy, functionality, and cost associated with the use of percutaneous techniques for the salvage of thrombosed immature fistulas.

Access flow reduction and recurrent symptomatic cephalic arch stenosis in brachiocephalic hemodialysis arteriovenous fistulas.

Background: Recurrent cephalic arch stenosis (CAS) has been linked to high flow and has a high rate of recurrence following angioplasty. This study investigates the effectiveness of access flow reduction in decreasing rapidly recurrent symptomatic CAS.

Methods: A retrospective study of patient records from February 2005 to April 2009 was conducted.