Endovascular Treatment for Central Venous Stenosis due to Central Vein Catheterization for Hemodialysis.
Central venous stenosis is usually due to previous catheter insertion in the subclavian vein or internal jugular vein. These patients usually present with swelling of the arm bearing the arterio-venous fistula and adequate hemodialysis is not feasible. Endovascular treatment includes balloon angioplasty and stenting, but there is early recurrence of stenosis. Balloon angioplasty is the first treatment of choice. Stent may be used if there is elastic recoil after angioplasty or there is recurrence of stenosis within three months after angioplasty. Endovascular irradiation and stent graft do not prolong the patency. The results of newer technique, like drug eluting stent and cutting balloon, have to be evaluated.
Kwok
Philip Chong-Hei
PC
Department of Radiology and Imaging, Queen Elizabeth Hospital, Kowloon, Hong Kong S.A.R..