Download PDF
Semin intervent Radiol 2022; 39(01): 051-055
DOI: 10.1055/s-0041-1742152
Review Article

Management of Central Venous Stenosis and Occlusion in Dialysis Patients

David M. Tabriz
1   Department of Vascular and Interventional Radiology, Rush University Medical Center, Chicago, Illinois
,
Bulent Arslan
1   Department of Vascular and Interventional Radiology, Rush University Medical Center, Chicago, Illinois
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Central venous occlusions (CVOs) of the major intrathoracic veins (jugular, subclavian, brachiocephalic, superior vena cava) can cause debilitating symptoms, negatively impact arteriovenous fistula/graft function, or limit potential access creation options in end-stage kidney disease (ESKD) utilizing hemodialysis (HD). This review summarizes the incidence, pathophysiology, indications/contraindications, and management options of CVOs in the ESKD on HD population and concludes with considerations and examples when planning endovascular central recanalization procedures, which have risen as the first-line management when appropriate.

Keywords

central venous stenosis - recanalization - hemodialysis - superior vena cava - interventional radiology


Publication History

Article published online:
18 February 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Goldstein SL, Ikizler TA, Zappitelli M, Silverstein DM, Ayus JC. Non-infected hemodialysis catheters are associated with increased inflammation compared to arteriovenous fistulas. Kidney Int 2009; 76 (10) 1063-1069
    CrossrefPubMedGoogle Scholar
  • 2 Forauer AR, Theoharis C. Histologic changes in the human vein wall adjacent to indwelling central venous catheters. J Vasc Interv Radiol 2003; 14 (9, Pt 1): 1163-1168
    CrossrefPubMedGoogle Scholar
  • 3 Oguzkurt L, Tercan F, Yildirim S, Torun D. Central venous stenosis in haemodialysis patients without a previous history of catheter placement. Eur J Radiol 2005; 55 (02) 237-242
    CrossrefPubMedGoogle Scholar
  • 4 Hernández D, Díaz F, Rufino M. et al. Subclavian vascular access stenosis in dialysis patients: natural history and risk factors. J Am Soc Nephrol 1998; 9 (08) 1507-1510
    CrossrefPubMedGoogle Scholar
  • 5 Taal MW, Chesterton LJ, McIntyre CW. Venography at insertion of tunnelled internal jugular vein dialysis catheters reveals significant occult stenosis. Nephrol Dial Transplant 2004; 19 (06) 1542-1545
    CrossrefPubMedGoogle Scholar
  • 6 MacRae JM, Ahmed A, Johnson N, Levin A, Kiaii M. Central vein stenosis: a common problem in patients on hemodialysis. ASAIO J 2005; 51 (01) 77-81
    CrossrefPubMedGoogle Scholar
  • 7 Lumsden AB, MacDonald MJ, Isiklar H. et al. Central venous stenosis in the hemodialysis patient: incidence and efficacy of endovascular treatment. Cardiovasc Surg 1997; 5 (05) 504-509
    CrossrefPubMedGoogle Scholar
  • 8 Schwab SJ, Quarles LD, Middleton JP, Cohan RH, Saeed M, Dennis VW. Hemodialysis-associated subclavian vein stenosis. Kidney Int 1988; 33 (06) 1156-1159
    CrossrefPubMedGoogle Scholar
  • 9 Lok CE, Huber TS, Lee T. et al; National Kidney Foundation. KDOQI clinical practice guideline for vascular access: 2019 update. Am J Kidney Dis 2020; 75 (4, Suppl 2): S1-S164
    CrossrefPubMedGoogle Scholar
  • 10 Cohen EI, Beck C, Garcia J. et al. Success rate and complications of sharp recanalization for treatment of central venous occlusions. Cardiovasc Intervent Radiol 2018; 41 (01) 73-79
    CrossrefPubMedGoogle Scholar
  • 11 Keller EJ, Gupta SA, Bondarev S, Sato KT, Vogelzang RL, Resnick SA. Single-center retrospective review of radiofrequency wire recanalization of refractory central venous occlusions. J Vasc Interv Radiol 2018; 29 (11) 1571-1577
    CrossrefPubMedGoogle Scholar
  • 12 Guimaraes M, Schonholz C, Hannegan C, Anderson MB, Shi J, Selby Jr B. Radiofrequency wire for the recanalization of central vein occlusions that have failed conventional endovascular techniques. J Vasc Interv Radiol 2012; 23 (08) 1016-1021
    CrossrefPubMedGoogle Scholar
  • 13 McGuckin JF, Gosnear AM, Williams RL. A new pathway for central venous occlusion. Endovasc Today 2009; (July): 86-88
    PubMedGoogle Scholar
  • 14 Farrell T, Lang EV, Barnhart W. Sharp recanalization of central venous occlusions. J Vasc Interv Radiol 1999; 10 (2, Pt 1): 149-154
    CrossrefPubMedGoogle Scholar
  • 15 Goo DE, Kim YJ, Choi DL. et al. Use of a Rosch-Uchida needle for recanalization of refractory dialysis-related central vein occlusion. AJR Am J Roentgenol 2010; 194 (05) 1352-1356
    CrossrefPubMedGoogle Scholar
  • 16 Honnef D, Wingen M, Günther RW, Haage P. Sharp central venous recanalization by means of a TIPS needle. Cardiovasc Intervent Radiol 2005; 28 (05) 673-676
    CrossrefPubMedGoogle Scholar
  • 17 Miller GA, Koh E, Khariton A. et al. Sharp needle recanalization for salvaging hemodialysis accesses with chronically occluded peripheral outflow. J Vasc Access 2012; 13 (01) 22-28
    CrossrefPubMedGoogle Scholar
  • 18 Brountzos EN, Preza O, Kelekis A, Panagiotou I, Kelekis N. Recanalization of dialysis catheter-related subclavian vein occlusion using a re-entry device: report of two patients. Cardiovasc Intervent Radiol 2011; 34 (01) 207-211
    CrossrefPubMedGoogle Scholar
  • 19 Anil G, Taneja M. Revascularization of an occluded brachiocephalic vein using Outback-LTD re-entry catheter. J Vasc Surg 2010; 52 (04) 1038-1040
    CrossrefPubMedGoogle Scholar
  • 20 Baetens TR, Rotmans JI, van der Meer RW, van Rijswijk CS. A novel technique to restore access in patients with central venous occlusion using the Surfacer® Inside-Out® Access Catheter System. J Vasc Access 2020; 21 (05) 778-782
    CrossrefPubMedGoogle Scholar