title: Shortening and migration of Wallstents after stenting of central venous stenoses in hemodialysis patients.
abstract: OBJECTIVE
  To report our results for the placement of central venous stents in patients undergoing hemodialysis.
  
  
  METHODS
  Ten Wallstents (Schneider, Bülach, Switzerland) were placed in 10 patients with shunt thrombosis, shunt dysfunction or arm swelling associated with central vein stenosis or occlusion. Technical success, patency and complications were evaluated.
  
  
  RESULTS
  Stent deployment was successful in all cases. In seven cases (70%) there was significant delayed stent shortening. In two of these cases there was also stent migration. All these cases required additional stents. Primary patency rates at 6, 12 and 24 months were 66%, 25% and 0. Twenty-three additional procedures (percutaneous transluminal angioplasty or stenting) were required to achieve secondary patency rates at 6, 12 and 24 months of 100%, 75% and 57%.
  
  
  CONCLUSIONS
  Stent placement in the central veins of dialysis patients has a high technical success rate resulting in symptomatic relief and preservation of access. Repeat interventions are required to maintain patency. Significant delayed shortening of the Wallstent occurred in 70% of patients which may have affected the patency rates. Strategies are suggested to avoid this problem.
authors.affiliation: Department of Radiology, Hadassah University Hospital, POB 12000, Ein Kerem, Jerusalem 91120, Israel.
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Verstandig
authors.forename: Allan I
authors.initials: AI
authors.lastname: Bloom
authors.forename: Talia
authors.initials: T
authors.lastname: Sasson
authors.forename: Y S
authors.initials: YS
authors.lastname: Haviv
authors.forename: D
authors.initials: D
authors.lastname: Rubinger
mesh_terms: D000368:Aged; D002405:Catheterization, Central Venous; D005260:Female; D005548:Foreign-Body Migration; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D006435:Renal Dialysis / Q000295:instrumentation*; D015607:Stents; D013350:Subclavian Vein; D016896:Treatment Outcome; D014654:Vascular Patency