Percutaneous Transluminal Angioplasty in Chronic Total Subclavian Venous Stenosis Using Coronary Guidewire: A Case Report

2021 ◽  
Author(s):  
Todung D. A. Silalahi ◽  
Christopher S. Suwita
Keyword(s):  
Success Rate ◽  
Subclavian Vein ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Alternative Technique ◽  
Stent Deployment ◽  
Total Occlusion ◽  
Venous Stenosis ◽  
Lower Success Rate ◽  
Percutaneous Transluminal

AbstractArteriovenous fistula is the best permanent vascular access for hemodialysis (HD). However, in our country, HD catheter in jugular or subclavian vein is more commonly found because our patients prefer to hold HD until the complications are unbearable. The catheter increases risk of venous stenosis on site and in surrounding vessels, resulting in access loss. Percutaneous transluminal angioplasty (PTA), combined with stent deployment, can be utilized as main treatment for such stenosis in subclavian vein. This method dated back to two decades ago with high success rate. Nevertheless, reports or studies of angioplasty in total occlusion are scarce, mainly because of lower success rate and the need of smaller penetrating wire. We describe our experience in performing PTA and stent deployment using coronary wire to penetrate total occlusion in subclavian venous stenosis after vein cannulation. We hope that we can give an alternative technique to avoid surgery in such cases.

scholarly journals Percutaneous transluminal angioplasty for central venous stenosis or occlusion in hemodialysis patients

2018 ◽  
Vol 20 (1_suppl) ◽  
pp. 87-92 ◽  
Author(s):  
Yuki Horita
Keyword(s):  
Percutaneous Transluminal Angioplasty ◽  
Interventional Therapy ◽  
Transluminal Angioplasty ◽  
Radial Force ◽  
Brachiocephalic Vein ◽  
Central Venous ◽  
Central Venous Stenosis ◽  
Venous Stenosis ◽  
The Right ◽  
Percutaneous Transluminal

The objectives of central venous percutaneous transluminal angioplasty are to dilate the venous lesion and to extend the life of arteriovenous fistula for hemodialysis. It is reasonable to perform percutaneous transluminal angioplasty for central venous lesions if this interventional therapy is required to maintain stable dialysis therapy. However, the presence of large fresh thrombus at central venous lesion site represents a contraindication to percutaneous transluminal angioplasty unless the thrombus can first be removed by thrombectomy. Balloon angioplasty is a basic treatment for central venous lesion, but stent implantation is sometimes required. The self-expandable or balloon-expandable stent is chosen by the lesion location and characteristics. The lesion in subclavian vein is generally treated by self-expandable stent and right brachiocephalic vein is treated by balloon-expandable stent. The organic lesion of innominate vein with plaque is treated by self-expandable stent. Note that the innominate venous stenosis is sometimes caused by compression between the right brachiocephalic artery and the sternum, and this lesion is treated by balloon-expandable stent because the radial force of balloon-expandable stent is stronger than self-expandable stent. It is important to understand the indication and stent selection for central venous percutaneous transluminal angioplasty.

Percutaneous transluminal angioplasty (PTA) and venous stenting in hemodialysis patients with vascular access-related venous stenosis or occlusion

Radiography ◽  
2006 ◽  
Vol 12 (2) ◽  
pp. 127-133 ◽  
Author(s):  
Fotini P. Christidou ◽  
Vasilios I. Kalpakidis ◽  
Kostas D. Iatrou ◽  
Ioannis A. Zervidis ◽  
Gerasimos I. Bamichas ◽  
...  
Keyword(s):  
Vascular Access ◽  
Percutaneous Transluminal Angioplasty ◽  
Hemodialysis Patients ◽  
Transluminal Angioplasty ◽  
Venous Stenting ◽  
Venous Stenosis ◽  
Percutaneous Transluminal

Percutaneous Transluminal Angioplasty of Supra-aortic Vessels

1996 ◽  
Vol 3 (2) ◽  
pp. 171-181 ◽  
Author(s):  
Amir Motarjeme
Keyword(s):  
Vertebral Artery ◽  
Percutaneous Transluminal Angioplasty ◽  
Carotid Arteries ◽  
Balloon Dilation ◽  
Percutaneous Treatment ◽  
Transluminal Angioplasty ◽  
Long Term Results ◽  
Percutaneous Technique ◽  
Stent Deployment ◽  
Percutaneous Transluminal

Purpose: To retrospectively review the techniques and results of percutaneous transluminal angioplasty (PTA) in the supra-aortic vessels. Methods: Over a 5-year period, 112 patients underwent percutaneous treatment of 151 lesions in the innominate, subclavian, carotid, and vertebral arteries. The percutaneous technique included standard retrograde femoral artery access in the majority of patients with balloon dilation of the lesion site. In the more recently treated patients, stents were deployed for suboptimal PTA; primary stent deployment was used rarely. Symptom resolution and > 50% increase in flow were criteria necessary for a successful procedure. Results: In this population, 141 (93%) of 151 lesions were successfully treated. PTA achieved 100% success in stenotic lesions in the internal (n = 9) and external (n = 2) carotid; common carotid (n = 8); subclavian (n = 67); and innominate (n = 13) arteries. Ninety-two percent (36/39) of vertebral artery stenoses were successfully treated. In 13 cases of subclavian occlusion, however, only 6 (46%) were recanalized. There were 3 periprocedural complications, but only 1 was major; a focal stroke manifesting as right arm weakness occurred in a patient with left common carotid PTA and stenting. Five cases of reocclusion have been seen in 5 years of follow-up. All occurred in the subclavian artery, and 3 of the 5 were in arteries originally occluded. Conclusions: Brachiocephalic PTA can achieve excellent immediate and long-term results in proximal stenoses. Subclavian occlusions do not respond well to PTA, and those successfully recanalized have a high restenosis rate (50%). PTA of the arch vessel branches, particularly the vertebral artery, should be attempted only by experienced interventionists. Atherosclerotic lesions in the internal carotid arteries are best treated with endarterectomy at present, but fibromuscular dysplasia in the carotid arteries is an appropriate indication for PTA therapy.

scholarly journals Percutaneous Transluminal Angioplasty and Stenting for Chronic Total Occlusion of Intracranial Carotid Artery

2006 ◽  
Vol 12 (3) ◽  
pp. 263-268 ◽  
Author(s):  
H. Ishihara ◽  
N. Sakai ◽  
T. Kuroiwa ◽  
M. Sakaguchi ◽  
A. Morizane ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Percutaneous Transluminal Angioplasty ◽  
Chronic Total Occlusion ◽  
Internal Carotid ◽  
Therapeutic Option ◽  
Transluminal Angioplasty ◽  
Total Occlusion ◽  
Cerebrovascular Lesions ◽  
Percutaneous Transluminal

Chronic total occlusion of cerebrovascular lesions is regarded as a contraindication to revascularization. We describe a case of chronic total occlusion of intracranial internal carotid artery that iwass successfully recanalized by endovascular treatment. A 72-year-old man who presented with slight right hemiparesis was proved to have chronic total occlusion of the left intracranial internal carotid artery. Percutaneous transluminal angioplasty/stenting was achieved using reversal of flow with the Parodi Anti-Embolic System. The present case indicates that percutaneous transluminal angioplasty/stenting can be an effective therapeutic option in selected patients with chronic total occlusion of cerebrovascular lesions.

scholarly journals HEMODIALYSIS;

2019 ◽  
Vol 26 (05) ◽  
Author(s):  
Amber Malik ◽  
Muhammad Tufail ◽  
Arz Muhammad
Keyword(s):  
Balloon Angioplasty ◽  
Percutaneous Transluminal Angioplasty ◽  
Patency Rate ◽  
Hemodialysis Patients ◽  
Transluminal Angioplasty ◽  
Central Venous ◽  
Central Venous Stenosis ◽  
Angioplasty Balloon ◽  
Venous Stenosis ◽  
Percutaneous Transluminal

Objective: To evaluate the treatment success rate of percutaneous transluminal angioplasty (balloon angioplasty) for peripheral and central venous stenosis in hemodialysis patients. Study Design: Retrospective/observational study. Place and Duration of Study: Department of Cardiology, Shaikh Zayed Hospital Lahore from 1st January 2018 to 30th June 2018. Methods: Thirteen patients of both genders presenting during from two years of hemodialysis failure and ipsilateral arm and neck swelling followed by peripheral and central venous stenosis were included in this study. Patients ages were ranging from 25 to 70 years. Patient’s detailed history including hemodialysis treatment, age, sex, socio-economic status was examined after taking informed consent from the patients. Percutaneous transluminal angioplasty (PTA) was performed at all the patients. Procedural success rate was examined. Results: There were 9 (69.23%) patients were men and rest (13.77%) were women. 5 (38.46%) patients were ages between 25 to 45 years, 6 (46.15%) patients had an ages 46 to 65 years and 2 (15.38%) patients were ages greater than 65 years. 10 (76.92%) had rural residency. 40 % patients had income >30000 PKR. Location and severity of lesions was examined as brachiocephalic vein, subclavian vein, Axillary vein, basilica, cephalic and median cubtal vein in 1,3,2,3,3 and 1 patients respectively. We determine priority patency rate in central lesion PTA was 82.7%, 62% and 38% at 3, 6 and 12 months and priority patency rate in peripheral lesions PTA was 87%, 79.5% and 67.8% at 3, 6 and 12 months. Conclusion: It is concluded that percutaneous transluminal angioplasty (balloon angioplasty) procedure for treatment of central and peripheral venous stenosis in hemodialysis patients was safe and effective with no procedural complications.

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