[Central venous stenting in patients on hemodialysis: review of our case series and long-term follow-up].
Aims of the study was validate the venous stenting technique as the treatment of choice in patients affected by stenosis or occlusion of the central venous area. To evaluate the long-term patency of placed stents in our series and to detect factors predisposing to restenosis. Twenty-three hemodialyzed patients were treated by PTA or placement of a metallic self-expandable stent in the central venous area because of occlusion or severe stenosis caused by repeated central venous access puncture for Port-A-Cath or pacemaker placement. All patients were examined every 3 months after treatment by clinical examination and color-Doppler ultrasound. Stents were placed with success in all cases but one, where it was impossible to get past the occlusion. Restenosis was observed in 12 cases at 4 to 12 months (average 8 months). Intrastent restenoses were treated with success by PTA alone and stent placement in 4 cases. A new restenosis was observed in 4 retreated patients in whom the stent was short or angled. In the other patients restenosis was attributable to disregard of anticoagulant therapy. In conclusions, the availability of new devices and dedicated stents is still necessary. There is a limited relationship between patency and wrong stent placement. Patients undergoing stenting should be controlled by clinical examination and color-Doppler ultrasound in hospitals where skilled interventional radiologists are available.
Patanè
D
D
UOC Diagnostica per Immagini, SS Angiografia e Radiologia Interventistica, Azianda Ospedaliera Cannizzaro, Catania, Italy. domenicopatane@alice.it
Morale
W
W
Malfa
P
P
Seminara
G
G
Caudullo
E
E
L'Anfusa
G
G
Spanti
D
D
Mandalà
M L
ML
Di Landro
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D006435:Renal Dialysis; D015607:Stents; D013997:Time Factors; D014654:Vascular Patency