Endovascular Management of Central Venous Stenosis in Haemodialysis Patients

Abstract
Aim of Study: Is to evaluate the patency of the endovascular management for the venous hypertension in haemodialysis access patient having upper limb AVF.
Patients and Methods: Fifty patients were recruited in this study, sixty percent of the patients were females, while 40% of patients were males. Mean age of patients was 47.77± 10.49 years. The AVF were native in 38 patients (76%) while synthetic AVFs were reported in 12 cases (24%). Sixty four percent of the patients had left sided AVF & the remaining 36% had right sided AVf. Patency rates of collectively 34 patients are 100%, 97%, 70% at 3, 6, 12 months respectively.
Results: Follow-up of a total of 34 successful cases after one year period revealed 24 cases were free of symptoms while 10 cases had recurrent symptoms. One year patency rate of cases with single lesion was 91.6%, and those with multiple lesions was 8.3% and that was statistically significant. One year patency rate for patients with lesions less than 3cm was 66.6% and for those with lesions more than 3cm was 33.3%. This was statistically insignificant with p=0.1.
Conclusions: Percutaneous central venous angioplasty could provide symptomatic relief in patients that present with central venous stenosis and upper-extremity edema. Compli-cations from PTA are infrequent. It offers a minimally invasive, first-line approach for a difficult problem in a patient population with significant comorbidities. However the durability of PTA is limited, and in most patients additional interventions are required to extend the symptom free period.