Metallic stent placement for treating peripheral outflow lesions in native arteriovenous fistula hemodialysis patients after insufficient balloon dilatation.
OBJECTIVE
The purpose of this study was to report our experience with metallic stent placement in the peripheral outflow veins in native arteriovenous fistula (A-V fistula) hemodialysis patients after insufficient balloon dilatation.


METHODS
During the past 4 years, 12 A-V fistula dialysis patients in our hospital underwent metallic stent placement in the peripheral outflow veins to restore vascular access. The indications for metallic stent placement in our study included (1) recoil stenosis of outflow vein in six patients; (2) outflow venous rupture in two patients and dissection in one patient; and (3) large residual adherent thrombus in outflow aneurysms in three patients with thrombosed (arteriovenous) access. Self-expandable Wallstent or Jostent (Jomed, Abbott Laboratories) of appropriate size (6-10 mm in diameter) was chosen for use in these patients. Kaplan-Meier survival analysis was used to calculate the access patency rates.


RESULTS
Twelve patients received stents. Eleven patients (92%) underwent successful dialysis after the procedure. One patient experienced complications due to incorrect positioning of the stent at the anastomotic site, causing flow compromise. The primary patency (+/- standard error) of the vascular access at 3, 6, 12, and 24 months was 92% +/- 8%, 81% +/- 12%, 31% +/- 17%, and 31% +/- 17%, respectively. The secondary patency of the vascular access at 3 months was 92% +/- 8%, and 82% +/- 12% at 6, 12, and 24 months each.


CONCLUSIONS
Metallic stent placement is safe and effective in treating peripheral venous lesions in native A-V fistula hemodialysis patients after unsatisfactory balloon dilatation.
Pan
Huay-Ben
HB
Department of Radiology, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1 Rd., Kaohsiung, Taiwan 813, ROC.
Liang
Huei-Lung
HL
Lin
Yih-Huie
YH
Chung
Hsiao-Min
HM
Wu
Tung-Ho
TH
Chen
Chiung-Yu
CY
Fang
Hua-Chang
HC
Chen
Clement K-H
CK
Lai
Pin-Hon
PH
Yang
Chien-Fang
CF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical; D002404:Catheterization; D003287:Contrast Media; D005260:Female; D006083:Graft Occlusion, Vascular / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D006435:Renal Dialysis / Q000295:instrumentation*; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency
D003287:Contrast Media