title: The Role of Endovascular Stents in Dialysis Access Maintenance.
abstract: Vascular stenosis is most often the culprit behind hemodialysis vascular access dysfunction, and although percutaneous transluminal angioplasty remains the gold standard treatment for vascular stenosis, over the past decade the use of stents as a treatment option has been on the rise. Aside from the 2 Food and Drug Administration-approved stent grafts for the treatment of venous graft anastomosis stenosis, use of all other stents in vascular access dysfunction is off-label. Kidney Disease Outcomes Quality Initiative recommends limiting stent use to specific conditions, such as elastic lesions and recurrent stenosis; otherwise, additional adapted indications are in procedure-related complications, such as grade 2 and 3 hematomas. Published reports have shown the potential use of stents in a variety of conditions leading to vascular access dysfunction, such as venous graft anastomosis stenosis, cephalic arch stenosis, central venous stenosis, dialysis access aneurysmal elimination, cardiac implantable electronic device-induced stenosis, and thrombosed arteriovenous grafts. Although further research is needed for many of these conditions, evidence for recommendations has been clear in some; for instance, we know now that stents should be avoided along cannulation sites and should not be used in eliminating dialysis access aneurysms. In this review article, we evaluate the available evidence for the use of stents in each of the aforementioned conditions leading to hemodialysis vascular access dysfunctions.
authors.affiliation: Interventional Nephrology Section, Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL; Vascular Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL; Division of Nephrology, Albany Medical College, Albany, NY; Internal Medicine Hospitalist Division, South Miami Hospital, South Miami, FL.
authors.forename: Mohamad
authors.initials: M
authors.lastname: El Kassem
authors.affiliation: Interventional Nephrology Section, Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL; Vascular Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL; Division of Nephrology, Albany Medical College, Albany, NY; Internal Medicine Hospitalist Division, South Miami Hospital, South Miami, FL.
authors.forename: Issam
authors.initials: I
authors.lastname: Alghamdi
authors.affiliation: Interventional Nephrology Section, Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL; Vascular Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL; Division of Nephrology, Albany Medical College, Albany, NY; Internal Medicine Hospitalist Division, South Miami Hospital, South Miami, FL.
authors.forename: Roberto I
authors.initials: RI
authors.lastname: Vazquez-Padron
authors.affiliation: Interventional Nephrology Section, Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL; Vascular Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL; Division of Nephrology, Albany Medical College, Albany, NY; Internal Medicine Hospitalist Division, South Miami Hospital, South Miami, FL.
authors.forename: Arif
authors.initials: A
authors.lastname: Asif
authors.affiliation: Interventional Nephrology Section, Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL; Vascular Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL; Division of Nephrology, Albany Medical College, Albany, NY; Internal Medicine Hospitalist Division, South Miami Hospital, South Miami, FL.
authors.forename: Oliver
authors.initials: O
authors.lastname: Lenz
authors.affiliation: Interventional Nephrology Section, Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL; Vascular Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL; Division of Nephrology, Albany Medical College, Albany, NY; Internal Medicine Hospitalist Division, South Miami Hospital, South Miami, FL.
authors.forename: Tina
authors.initials: T
authors.lastname: Sanjar
authors.affiliation: Interventional Nephrology Section, Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL; Vascular Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL; Division of Nephrology, Albany Medical College, Albany, NY; Internal Medicine Hospitalist Division, South Miami Hospital, South Miami, FL.
authors.forename: Fadi
authors.initials: F
authors.lastname: Fayad
authors.affiliation: Interventional Nephrology Section, Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL; Vascular Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL; Division of Nephrology, Albany Medical College, Albany, NY; Internal Medicine Hospitalist Division, South Miami Hospital, South Miami, FL. Electronic address: lsalman@med.miami.edu.
authors.forename: Loay
authors.initials: L
authors.lastname: Salman
mesh_terms: D000783:Aneurysm / Q000601:surgery*; D017541:Aneurysm, False / Q000601:surgery*; D017130:Angioplasty / Q000379:methods*; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D003251:Constriction, Pathologic / Q000628:therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D011183:Postoperative Complications / Q000628:therapy*; D006435:Renal Dialysis; D015607:Stents; D013927:Thrombosis / Q000601:surgery*
keywords: Aneurysms; CIED; Cephalic arch stenosis; Dialysis access dysfunction; Stents