scholarly journals Central vein rupture during percutaneous transluminal angioplasty for central vein stenosis or occlusion in haemodialysis patients

2017 ◽  
Vol 21 (1) ◽  
Author(s):  
Young J. Kim ◽  
Seung B. Yang ◽  
Woong H. Lee ◽  
Yong J. Kim ◽  
Jae M. Lee ◽  
...  
Keyword(s):  
Percutaneous Transluminal Angioplasty ◽  
Guide Wire ◽  
Transluminal Angioplasty ◽  
Central Vein ◽  
Chi Square ◽  
Central Venous Stenosis ◽  
Chi Square Test ◽  
Vein Stenosis ◽  
Percutaneous Transluminal ◽  
Central Vein Stenosis

Background: Endovascular treatments such as percutaneous transluminal angioplasty (PTA) and stent placements are becoming the standard method in managing haemodialysis access failure. Venous rupture is the most common complication during endovascular procedures. Complications during endovascular treatments of central venous stenosis or occlusion have been rarely reported.Objectives: To investigate the incidence and management of central vein rupture while performing PTA for central vein stenosis or occlusion in haemodialysis patients.Method: Between 1998 and 2013, PTA was performed using various techniques in haemodialysis patients for central vein stenoses (n = 2437) and occlusions (n = 666). When the guide wire passed through the stenosis or the occlusion, PTA was performed regardless of the presence of a venous rupture. The incidence of central vein rupture was analysed using the chi-square test according to the gender, location, right versus left, presence of thrombosis and stenosis versus occlusion. Percutaneous management of central vein rupture was also evaluated.Results: Central vein rupture occurred in 12 cases (0.39%). All ruptures occurred in the cases with occlusion. Only stenosis versus occlusion reflected a significant correlation (p < 0.001) with central vein rupture. Central vein ruptures were managed by low-pressure balloon tamponade (n = 2), stent/stent-graft (n = 5) and balloon-mediated haemostasis blocking venous inflow followed by the observation (n = 5).Conclusion: Central vein rupture is a rarely occurring complication while performing PTA for central vein stenosis and occlusion, and the majority can be successfully managed by percutaneous techniques.

Solutions to stuck tunneled cuffed catheters in patients undergoing maintenance hemodialysis

2020 ◽  
pp. 112972982092816
Author(s):  
He Yongchun ◽  
Jiang Hua ◽  
Huang Xiaohan ◽  
Chen Jianghua ◽  
Zhang Ping
Keyword(s):  
Success Rate ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Maintenance Hemodialysis ◽  
Central Vein ◽  
Blunt Dissection ◽  
First Choice ◽  
Vein Stenosis ◽  
Percutaneous Transluminal

Objective: To study and discuss treatments for stuck tunneled cuffed catheter in patients undergoing maintenance hemodialysis. Method: Retrospectively analyzing clinical data of 13 patients with stuck tunneled cuffed catheter in the Kidney Disease Center of the First Affiliated Hospital, College of Medicine, Zhejiang University in the period between September 2012 and October 2018. All patients failed to remove hemodialysis catheters by regular technique. The stuck catheters were treated by thoracotomy, endoluminal percutaneous transluminal angioplasty with blunt dissection or embedded and left in situ. Results: In 13 patients, one was successfully treated by thoracotomy, one failed to remove the catheter by regular technique and blunt dissection, and the stump of the catheter was clamped and buried in the subcutaneous fascia of the neck, and the other 11 were treated by endoluminal percutaneous transluminal angioplasty with blunt dissection. The average time of catheter removal procedure is 25 min, the overall success rate is 92.3%, and the success rate of percutaneous transluminal angioplasty is 100%. Conclusion: Thoracotomy is an efficient way to treat stuck catheter but is limited by its high risk and complications. Leaving part of catheter in situ may increase the risk of central vein stenosis. Comparing to the former two, endoluminal percutaneous transluminal angioplasty is a safe, efficient, and practical way for stuck catheters and should be recommended as the first choice.

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.

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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