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Date Published: 29/01/2021
Online Published: 01/02/2021
Abstract Views: 295
Views PDF: 392
DOI: https://doi.org/10.47972/vjcts.v31i.499
Issue
Vol. 31
Section
Research Article
How to Cite
Bao, D. D., & Tien, T. Q. (2021). The results of endovascular treatment of central venous stenosis or obstruction on hemodialysis patient. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 31, 27-33. https://doi.org/10.47972/vjcts.v31i.499

The results of endovascular treatment of central venous stenosis or obstruction on hemodialysis patient

Dương Đình Bảo , Trần Quyết Tiến

Main Article Content

Abstract

Objective: This study aimed to evaluate the results of endovascular management of the central venous stenosis or obstruction (CVD) in hemodialysis (HD) patients via ipsilateral arteriovenous fistula (AVF).


Methods: Retrospective method with HD patients treated CVD by interventional therapy using balloon or stent, at Vascular Surgery department of Cho Ray hospital from January 2017 to December 2019.


Results: There were 32 cases of central venoplasty with local anesthesia via ipsilateral AVF. The average age was 55,6 ± 3,2, the male/female ratio was 1,67/1. Interventional indications were arm swelling (100%), pain in the arm (75%), skin dystrophy (50%), dilated veins in the ipsilateral neck and face (50%). 62,5% of them had a history of catheterization which was ipsilateral to lession. Each procedure had the average time 66,3 ± 6,2 minutes. Stent placement was followed after ineffective baloon angioplasty in 6 cases. The technique success rate was 87,5%. There was no major complication and death perioperatively. The symptoms of venous hypertension were resolved after intervention in all cases. The postoperative average time in the hospital was around 2,5 ± 0,8 days. After 6 months, there were 10 cases (31,3%) required to re-endovascular treatment.


 Conclusions: The endovascular intervention is a safe and effective method for CVD because of good rate of technical success, low rate of complications, reducing the duration of procedure and discharge. However, the disease has a high recurrence rate. Enhanced follow-up and repeated interventions are required to maintain the patency for long term.


 

Article Details

Keywords

Central venous stenosis or obstruction, hemodialysis, endovascular treatment

References

1. Thái Minh Sâm và cộng sự (2011), Phẫu thuật tạo dò động tĩnh mạch để chạy thận nhân tạo tại bệnh viện chợ rẫy từ 1/2008 đến 5/2010, Tạp chí Y Học TP. HCM, 15(4).
2. Aktas A., Bozkurt A., Aktas B., et al. (2015). Percutaneous transluminal balloon angioplasty in stenosis of native hemodialysis arteriovenous fistulas: technical success and analysis of factors affecting postprocedural fistula patency. Diagn Interv Radiol, 21(2), 160-6.
3. Gary A. C., Zhiwen J. L., Justin K., Sadhana C., and Glenn W. L. T. (2018). “Outcomes of Central Venoplasty in Haemodialysis Patients. Ann Vasc Dis, 11(3), p 292 –297.
4. Gerald A. B. (2017). Endovascular intervention for the treatment of stenosis in the arteriovenous access. Uptodate.
5. Maga P. (2016). Endovascular treatment of dysfunctional arteriovenous fistula in hemodialyzed patients — the results of one year follow-up. Via medica, 22(4), 143-149.
6. Mark K. E., Mark D. M., William H. P., James S. T. (2011), Contemporary Vascular Surgery. People’s Medical Publishing House, USA, 383-435.
7. Mickley V. (2006). Central vein obstruction in vascular access. Eur J Vasc Endovasc Surg, 32, 439-444.
8. Shi Y., Ye M., Liang W., Zhang H., Zhao Y. and Zhang J. (2013). Endovascular treatment of central venous stenosis and obstruction in hemodialysis patients. Chin Med J, 126 (3).
9. Sidhu A., Tan K. T., Noel-Lamy M., et al. (2016). Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?. Cardiovasc Intervent Radiol, 39(10), 1400-6.