ENDOVASCULAR TREATMENT OF CENTRAL VEIN STENOSIS OR OCCLUSION IN HEMODIALYSIS PATIENTS
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Background: A reliable vascular access, preferably an arteriovenous fistula (AVF) is the lifeline of hemodialysis patients. Fistula function may be impaired by subclavian stenosis or occlusion, mainly due to previous subclavian cannulation for temporary vascular access. Currently, there has been a significant improvement in the life span of haemodialysis patients, thus it is very important to maintain vascular access as long as we can. Objective: To evaluate the efficacy of endovascular treatment for upper extremity central venous stenosis or obstruction in chronic hemodialysis patients. Patients and methods: Between January 2003 to May 2004,20 balloon angioplasty procedures with or without stent were performed for 13 patients who have chronic renal failure and venous hypertension due to central venous stenosis or occlusion. Remits: All procedures were technically successful with no major complications. Seven patients needed reintervention within the 1st year of follow-up. Primary patency rate were 84.6%, 69.2% and 46.2% at 3, 6 and 12 months respectively. All patients with repeated dilatation had no major complications. Conclusion: Endovascular treatment of central vein stenosis or occlusion is an effective alternative to surgery. Regular follow-up and repeated dilatation are indicated to prolong the life of the vascular access.