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Treatment of central venous in-stent restenosis with repeat stent deployment in hemodialysis patients

Abstract

Purpose

To report patency rates for stent deployment for treatment of in-stent stenosis of the central veins of the chest in hemodialysis patients.

Materials and methods

A retrospective analysis was performed on 29 patients who underwent 35 secondary percutaneous transluminal stent (PTS) deployments for in-stent stenosis within the central veins that were refractory to angioplasty and ipsilateral to a functioning hemodialysis access (in-stent PTS group). For comparison, patency data were acquired for 47 patients who underwent 78 successful percutaneous transluminal angioplasty (PTA) procedures for in-stent stenosis (in-stent PTA group) and 55 patients who underwent 55 stent deployments within native central vein stenosis refractory to angioplasty (native vein PTS group).

Results

The 3-, 6-, and 12-month primary lesion patency for the in-stent PTS group was 73%, 57%, and 32%, respectively. The 3-, 6-, and 12-month primary patency for the in-stent PTA group was 70%, 38%, and 17% and for the native vein PTS group was 78%, 57%, and 26%, which were similar to the in-stent PTS group (p = 0.20 and 0.41, respectively). The 3-, 6-, and 12-month secondary access patency was 91%, 73%, and 65% for the in-stent PTS group. Sub-analysis of the in-stent PTS group revealed no difference in primary (p = 0.93) or secondary patency rates (p = 0.27) of bare metal stents (n = 23) compared with stent grafts (n = 12).

Conclusions

Stent deployment for central vein in-stent stenosis refractory to angioplasty was associated with reasonable patency rates, which were similar to in-stent PTA and native vein PTS.

J Vasc Access 2017; 18(3): 214 - 219

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/jva.5000705

Authors

James Ronald, Bradley Davis, Carlos J. Guevara, Waleska M. Pabon-Ramos, Tony P. Smith, Charles Y. Kim

Article History

Disclosures

Financial support: No grants or funding have been received for this study.
Conflict of interest: None of the authors has financial interest related to this study to disclose.

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Authors

Affiliations

  •  Division of Vascular and Interventional Radiology, Duke University Medical Center, Durham, NC - USA
  •  Division of Vascular and Interventional Radiology, Mallinckrodt Institute of Radiology, St Louis, MO - USA

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