Shortening and migration of Wallstents after stenting of central venous stenoses in hemodialysis patients.
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.
Verstandig
Anthony G
AG
Department of Radiology, Hadassah University Hospital, POB 12000, Ein Kerem, Jerusalem 91120, Israel.
Bloom
Allan I
AI
Sasson
Talia
T
Haviv
Y S
YS
Rubinger
D
D
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