Use of Wallstents for hemodialysis access-related venous stenoses and occlusions untreatable with balloon angioplasty.
OBJECTIVE
To determine whether the Wallstent endoluminal prosthesis can be used to maintain patency of venous stenoses and occlusions related to hemodialysis access.


METHODS
Wallstents were placed in 52 patients with 56 lesions. Thirty-two lesions were in central veins and 24 were in peripheral veins. Stents were placed immediately after failed angioplasty in 39 patients, because of early restenosis after angioplasty in four, and for treatment of a lesion unsuitable for angioplasty in eight. The remaining five lesions were treated at the operator's discretion after predilation.


RESULTS
The procedural success rate was 96%. The cumulative primary patency rate was 46% at 6 months and 20% at 12 months; however, with repeat treatment, the cumulative assisted patency rate was 76% at 6 months and 33% at 12 months. Known causes of recurrence included intimal hyperplasia in or near the stent, stent slippage, and remote stenoses. Complications included two stent migrations due to central line placement and one stent-related pseudoaneurysm.


CONCLUSIONS
Wallstents are safe to deploy for dialysis access. Wallstents are useful for treating lesions that fail angioplasty and catheter-related central venous occlusions.
Gray
R J
RJ
Department of Radiology, Washington Hospital Center, Washington, DC 20010, USA.
Horton
K M
KM
Dolmatch
B L
BL
Rundback
J H
JH
Anaise
D
D
Aquino
A O
AO
Currier
C B
CB
Light
J A
JA
Sasaki
T M
TM
D000800:Angioplasty, Balloon; D001166:Arteriovenous Shunt, Surgical; D001807:Blood Vessel Prosthesis; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012008:Recurrence; D006435:Renal Dialysis; D015607:Stents; D017211:Treatment Failure; D014654:Vascular Patency