: To review the outcomes of central venoplasty in the treatment of symptomatic central vein stenosis in patients undergoing haemodialysis via an ipsilateral arteriovenous fistula (AVF). : Data were collected retrospectively, and included all the consecutive cases of central venoplasty between January 2008 and December 2015. : A total of 132 central venoplasties in 76 patients were performed, with incidence of symptomatic central vein stenosis at 7.4%. Of the patients, 66% were male and the mean age was 61 years. The most frequent indication was decreased dialysis access flow rates (58%) and 52% of all the patients had symptoms of upper limb swelling. The patients who had previous ipsilateral tunneled internal jugular vein dialysis catheters made up 58% of the patients. The mean time from AVF creation to first central venoplasty was 24 months, and 74% of the cases required a second central venoplasty and the mean time to second venoplasty was 7 months. The overall post intervention assisted primary patency rate was 87%, 74%, 63%, and 42% at 6, 12, 18, and 24 months respectively. Statistically significant differences were found in primary assisted patency (p=0.025) and time to second procedure (p=0.039) comparing those with and without a history of ipsilateral tunneled dialysis catheter. : Central venoplasty is technically feasible with low procedural risk. The maintenance of the AVF patency usually requires multiple procedures at average interval of 7 months. Patients with a history of upper limb tunneled dialysis catheter ipsilateral to the side of central vein stenosis or AVF have a less favorable outcome compared to those without.
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http://dx.doi.org/10.3400/avd.oa.18-00025 | DOI Listing |
Orphanet J Rare Dis
October 2024
Heart, Lung and Vessels Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China.
Background: Fibrosing mediastinitis (FM) is a rare yet fatal condition, caused by different triggers and frequently culminating in the obstruction of the pulmonary vasculature and airways, often leading to pulmonary hypertension and right heart failure. Percutaneous transluminal pulmonary venoplasty (PTPV) is an emerging treatment for pulmonary vein stenosis (PVS) caused by FM. Our previous study showed as high as 24% of in-stent restenosis (ISR) in FM.
View Article and Find Full Text PDFCardiovasc Intervent Radiol
December 2024
Department for Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany.
Obstructions of the superior and inferior vena cava are prevalent etiologies of deep venous obstruction, presenting a spectrum of clinical manifestations ranging from life-threatening conditions to asymptomatic states. The etiological diversity inherent to these central venous obstructions necessitates a subtle approach to their diagnosis and management. This discrepancy in clinical presentations emphasizes the importance of a differentiated diagnostic and therapeutic strategy, tailored to the specific form of vena cava obstruction encountered.
View Article and Find Full Text PDFNephrology (Carlton)
December 2024
Department of Radiology, IQRAA International Hospital and Research Centre, Calicut, India.
End-stage renal disease (ESRD) patients frequently encounter challenges at the time of dialysis catheter insertion from concomitantly associated with thoracic central venous obstruction (TCVO). TCVO complicates the placement of tunnelled dialysis catheters (TDCs). In cases where TCVO is unexpectedly encountered and TDC insertion becomes difficult, central venoplasty followed by catheter reinsertion is required.
View Article and Find Full Text PDFJ Clin Med
August 2024
Clinic of Phlebology, 02-034 Warsaw, Poland.
The endovenous embolization of insufficient abdominal/pelvic veins is the preferred method of treatment. Also, it seems to be crucial in the treatment of lower limb vein insufficiency, particularly in recurrent disease. This study aimed to evaluate of pelvic vein embolization safety and its impact on the short-term outcome in the sequential treatment of venous disease.
View Article and Find Full Text PDFJ Vasc Access
May 2024
Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore.
Aim: Arteriovenous fistula (AVF) dysfunction resulting from stenosis or occlusion, is a prevalent issue in end-stage renal failure patients reliant on autogenous AVFs for dialysis. Recently, a distal transradial approach (dTRA) has emerged, offering advantages such as diminished access site complications, better patient comfort and reduced risk of radial artery occlusion. Our study seeks to assess the effectiveness, outcomes and complication rates of employing dTRA for arteriovenous fistuloplasty in Singaporean patients.
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