Percutaneous Venoplasty for Central Venous Stenosis: Effect on Patient's Symptoms and Patency of Arteriovenous Accesses

Objectives: To determine symptomatic relief and patency rate of arteriovenous (AV) fistulae and grafts and after venoplasty in patients with central venous stenosis (CVS) on hemodialysis. Methods: Study Design: Retrospective case series. Place and Duration of the Study: Aga Khan University Hospital, Karachi, January 2012 to December 2017. Methodology: The data of patients who had one session of successful venoplasty for CVS were reviewed. The outcomes measured were symptomatic recovery and improvement in the patency of AV accesses. Symptomatic recovery was termed “complete,” when there was complete symptomatic relief after venoplasty, and “partial,” when there was technically successful procedure but symptoms were not resolved. Primary patency of AV access is the duration from first intervention till the further intervention. Cumulative patency was total duration of time fistula remain patent with multiple interventions. Events considered end points to functional access status were placement of new access site, ligation of access site, dialysis catheter placement, or the patient death. Results: Thirty-five patients had technically successful PTA with a mean age of 56.86 (±14.6) years. Twenty-one (60%) were female patients. All patients tolerated the procedure well. Twenty-one (60%) patients had complete relief of symptoms. Fourteen patients (40%) had partial relief of symptoms. Twenty-one patients required repeat angioplasty. The mean follow-up was 18.6 (±9.02) months. Primary patency was 40%, 24%, and 24% at 6, 12, and 24 months. Cumulative patency was 69%, 66%, and 59% at 6, 12, and 24 months. Conclusion: Percutaneous venoplasty provided symptomatic relief to the patients and improved the short-term patency of AV accesses.

Publication History

Article published online:
26 April 2021