Wallstent deployment to salvage dialysis graft thrombolysis complicated by venous rupture: early and intermediate results.

Funaki, Brian; Szymski, George X.; Leef, Jeffrey A.; Rosenblum, Jordan D.; Burke, Renee; Hackworth, C A

doi:10.2214/ajr.169.5.9353476

Cited by 60 publications

(30 citation statements)

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“…The application of this technique to vascular access intervention was first rigorously described in 1997 (68). Funaki et al (68) reported on 23 patients who were treated with covered stent placement after venous rupture attributed to balloon angioplasty during thrombectomy procedures.…”

Section: Stents and Vascular Access Emergenciesmentioning

confidence: 99%

Stent Placement in Hemodialysis Access

Yevzlin

Asif

2009

Clinical Journal of the American Society of Nephrology

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Vascular access stenosis in patients undergoing chronic hemodialysis is a major issue that is associated with increased morbidity, mortality, and cost of medical care. Recent data have emphasized that endovascular stents could be used in the treatment of central as well as peripheral stenotic lesions. In general, a peripheral or central vein lesion that is elastic or recurs within a three-month period after an initially successful balloon angioplasty or a stenosis where surgical revision is not possible are some indications for intravascular stent placement. Recent reports have expanded the role of stents in the management of pseudoaneurysms associated with dialysis access. In this context, the utilization of these devices must take into account a fair comparison with the traditional (surgical) approaches regarding effectiveness as well as costs. This report describes the role of stents in arteriovenous dialysis access. In addition, some of the recent advances in the structure and complicating issues such as stent fracture, migration, and infection, as well cannulation through the stent, are discussed.

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Section: Stents and Vascular Access Emergenciesmentioning

confidence: 99%

Stent Placement in Hemodialysis Access

Yevzlin

Asif

2009

Clinical Journal of the American Society of Nephrology

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“…Rupture of the venous outflow of arteriovenous shunts occurs in 2 to 3% of angioplasty procedures. 8,9 The routine use of bare stents to salvage shunt thrombolysis complicated by venous rupture was first described by Funaki et al 9 Because the alternative for most patients would be loss of the dialysis shunt, stents are now indicated as a firstline treatment for venous rupture related to angioplasty. For this reason, when performing post-angioplasty venograms of dialysis grafts and fistulae, I recommend maintaining wire access across all stenotic lesions prone to rupture-especially tight lesions or lesions at the cephalic arch.…”

Section: Stent Placement In Peripheral Venous Stenosesmentioning

confidence: 99%

“…9 Therefore, the stent provides a lowpressure conduit through which blood can flow. Support for this mechanism comes from the fact that this treatment is successful despite the presence of therapeutic blood levels of anticoagulant and thrombolytic medications, preventing healing of the venous rift by the normal coagulation cascade.…”

Section: Stent Placement In Peripheral Venous Stenosesmentioning

confidence: 99%

“…As Table 1 shows, patency rates following stent placement across venous ruptures are comparable to those following venous stenting for other indications. 8,9 Treatment of Pseudoaneurysms Pseudoaneurysm formation is a common occurrence in patients with dialysis shunts, particularly native fistulae. They are usually caused by frequent punctures at the same location at the time of dialysis, 11 despite the fact that Guidelines 27 and 28 of the Dialysis Outcomes Quality Initiative (DOQI.…”

Section: Stent Placement In Peripheral Venous Stenosesmentioning

confidence: 99%

“…Over the past 5 years, primary and secondary assisted patency rates for central venous stenosis have become increasingly well defined, and marked improvement over the initial results has been achieved (Table 2). 9,[17][18][19] In addition, even temporary patency achieved through this minimally invasive treatment has significant implications for patients with chronic renal failure in terms of morbidity and mortality.…”

Section: Central Venous Stenosismentioning

confidence: 99%

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Use of Stents for the Maintenance of Hemodialysis Access

Lorenz¹

2004

Semin intervent Radiol

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Maintenance of patent hemodialysis access is critical to prolonging the lives of patients with end-stage renal disease, and metallic stents have become a key tool for this purpose. This article discusses the primary and secondary indications for stent placement in dialysis patients, including angioplasty-induced acute venous rupture, central venous obstruction, early recurring stenosis, elastic stenosis and pseudoaneurysm. The use of stents in patients with synthetic arteriovenous grafts and native arteriovenous fistulae are discussed. With ongoing advances in stent technology as well as brachytherapy, the role of this device in the maintenance of dialysis access will likely increase. An understanding of the indications, precautions, and complications of stent deployment allows the interventional radiologist to become a principle player in the long-term care of dialysis patients.

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Venous rupture during percutaneous treatment of hemodialysis fistulas and grafts

Bittl¹

2009

Cathet Cardio Intervent

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Wallstent deployment to salvage dialysis graft thrombolysis complicated by venous rupture: early and intermediate results.

Cited by 60 publications

References 0 publications

Stent Placement in Hemodialysis Access

Stent Placement in Hemodialysis Access

Use of Stents for the Maintenance of Hemodialysis Access

Venous rupture during percutaneous treatment of hemodialysis fistulas and grafts

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