Back to the list
Congress: ECR24
Poster Number: C-15543
Type: EPOS Radiologist (scientific)
Authorblock: A. N. Vázquez Tobías, C. G. HINOJOSA GUTIERREZ, R. Perez-Milan; Leon/MX
Disclosures:
Adolfo Natanael Vázquez Tobías: Nothing to disclose
CARLOS GUILLERMO HINOJOSA GUTIERREZ: Nothing to disclose
Rafael Perez-Milan: Nothing to disclose
Keywords: Interventional vascular, Catheter venography, Angioplasty, Embolism / Thrombosis
Purpose Central venous stenosis (CVS) is a known complication presenting in patients with end-stage renal disease who have been subjected to the insertion of a central venous line, particularly a hemodialysis catheter. CVS can be asymptomatic, but it can present as superior vena cava syndrome. It can also cause hemodialysis acess dysfunction/exhaustion (arteriovenous fistula, hemodialysis catheter, etc), precluding the patient from receiving dialyitic support.Endovascular approach has become the preferred method to restablish vessel patency in such cases. Multiple techniques to achieve...
Read more Methods and materials Between march of 2022 and may of 2023,13 recanalization procedures for central vein occlusion were performed. Among the procedures, initial passage of a guidewire through an occlusion failed in 10 procedures on 10 patients. In these patients, recanalization was attempted with our modified technique, and these 10 patients constitute the sample for this study.Technical OverviewAll patients had a CT venogram performed for procedure planning. Superior (jugular/subclavian) and inferior (common femoral) venous accesses were secured with 6Fr femoral sheaths. Angiographic control...
Read more Results The patients were 3 men and 7 women (mean age, 36 ± 15.9 [SD] years; range, 16-63 years). The patients had undergone hemodialysis for 2–12 years. All patients had a history of central vein catheterization. The mean time from central vein stenosis diagnosis to the procedure was 2 years. The occlusions were in the superior vena cava in three patients, the right brachiocephalic vein in five patients, and the left brachiocephalic vein in two patients. Technical success in crossing the stenosed site...
Read more Conclusion Central vein stenosis is a commonly encountered problem in patients undergoing long-term hemodialysis. It is strongly related to previous central venous catheterization (1). Arteriovenous fistula status (high flow status) and subclavian vein cannulation are associated with higher rates of CVS (2). Stenosis can be asymptomatic, or result in venous hypertension, arm swelling, pain, and skin ulceration, arteriovenous fistula malfunction, as well as superior vena cava syndrome. The open surgical method has shown to have good patency rates; however, the complexity of...
Read more References 1.MacRae JM, Ahmed A, Johnson N, Levin A, Kiaii M. Central vein stenosis: a common problem in patients on hemodialysis. ASAIO J. 2005 Jan-Feb;51(1):77-81.2.Dhingra RK, Young EW, Hulbert-Shearon TE, Leavey SF, Port FK: Type of vascular access and mortality in U. S. hemodialysis patients. Kidney Int 60: 1443–1451, 2001.3.Belül I, Ali F, Hüseyin YB. Endovascular treatment options in central venous stenosis and occlusion: angioplasty or stent? Ankara Med J, 2020;(1):242-250.4.Kitrou P, Katsanos K, Karnabatidis D. Management of Central Venous Stenoses...
Read more
GALLERY