title: Endovascular treatment of central venous obstruction as a complication of prolonged hemodialysis - Preliminary experience in a tertiary care center.
abstract: BACKGROUND
  Central venous disease is a serious complication in patients undergoing hemodialysis, often presenting with symptoms of venous hypertension. Treatment is aimed to provide symptomatic relief and to maintain hemodialysis access site patency.
  
  
  OBJECTIVE
  To describe our initial experience in the endovascular treatment of central venous stenosis or obstruction in patients undergoing hemodialysis.
  
  
  METHODS
  This was a retrospective study carried out in a tertiary care center. Study duration was 24 months. Follow-up was variable.
  
  
  METHODS
  Eleven patients of chronic renal failure undergoing hemodialysis presented with central vein stenosis or obstruction having ipsilateral vascular access, between July 2012 and July 2014. All the patients underwent endovascular treatment and were analyzed retrospectively.
  
  
  CONCLUSIONS
  A total of 11 patients (4 male and 7 female) underwent 18 interventions for 13 stenotic segments during a time period of 2 years. Eight stenotic segments were in brachiocephalic vein, three in subclavian vein, and two in axillary veins. The technical success rate for endovascular treatment was 81.8%. Two patients underwent percutaneous transluminal angioplasty (PTA) alone and presented with restenosis later. Balloon angioplasty followed by stenting was done in seven patients, two of which required reintervention during follow-up. We found endovascular treatment safe and effective in treating central venous disease.
authors.affiliation: Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India.
authors.forename: Mukesh K
authors.initials: MK
authors.lastname: Yadav
authors.affiliation: Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India.
authors.forename: Madhurima
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India.
authors.forename: Anupam
authors.initials: A
authors.lastname: Lal
authors.affiliation: Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Gupta
authors.affiliation: Department of Transplant Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Khandelwal
keywords: Angioplasty; central venous stenosis; endovascular; hemodialysis; stenting