Abstract
Arteriovenous 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.
Keywords
angioplasty - arteriovenous fistula - coronary guidewire - subclavian vein - total
occlusion
