Early experience with the Abre venous stent for central venous stenoses and occlusions in hemodialysis patients.

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  • Additional Information
    • Source:
      Publisher: Sage Publications Country of Publication: United States NLM ID: 100940729 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1724-6032 (Electronic) Linking ISSN: 11297298 NLM ISO Abbreviation: J Vasc Access Subsets: MEDLINE
    • Publication Information:
      Publication: 2018- : Thousand Oaks, CA : Sage Publications
      Original Publication: Milano ; Birmingham : Wichtig, c2000-
    • Subject Terms:
      Renal Dialysis* ; Vascular Patency* ; Stents* ; Graft Occlusion, Vascular*/etiology ; Graft Occlusion, Vascular*/physiopathology ; Graft Occlusion, Vascular*/therapy ; Graft Occlusion, Vascular*/diagnostic imaging ; Arteriovenous Shunt, Surgical*/adverse effects ; Databases, Factual*; Humans ; Male ; Female ; Retrospective Studies ; Middle Aged ; Aged ; Treatment Outcome ; Time Factors ; Catheterization, Central Venous/adverse effects ; Catheterization, Central Venous/instrumentation ; Constriction, Pathologic ; Prosthesis Design ; Endovascular Procedures/instrumentation ; Endovascular Procedures/adverse effects ; Angioplasty, Balloon/instrumentation ; Angioplasty, Balloon/adverse effects
    • Abstract:
      Background: Hemodialysis patients are prone to stenoses and occlusions throughout the access circuit. Central venous stenoses or occlusions (CVO) can be particularly challenging. There are many different types of balloons and stents available for treatment, including a new generation of dedicated venous stents (VS). In this study, we report our experience and patency rates with the Abre VS in central venous lesions in hemodialysis patients.
      Methods: From April 2020 to May 2023, all procedures with Abre VSs placed for central venous lesions in hemodialysis patients were retrospectively analyzed from a prospectively collected database of 980 hemodialysis access interventions. Follow up outcomes were obtained from angiographic images on follow up angiography and included primary patency and primary assisted patency. Effective hemodialysis was considered a surrogate for access patency if no angiographic follow-up was available.
      Results: A total of 15 patients with CVO were treated with the Abre VS. Technical success was 100%. All patients were able to achieve adequate hemodialysis after VS placement. Stents were placed across the thoracic inlet in 73% of patients. Post procedure primary patency at the target lesion site was 85% at 6 months and 70% at 12 months. Primary assisted patency of the circuit was 93% at 6 and 12 months. No stent fractures were observed.
      Conclusion: Treatment of CVO remains extremely challenging, especially when the lesion is located at the thoracic inlet. In these patients, VSs provide acceptable primary patency rates and allow patients to continue to receive effective hemodialysis. However, routine follow-up and re-interventions will likely be necessary to maintain patency in the long term.
      Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
    • Contributed Indexing:
      Keywords: AV fistula; Techniques and procedures; dialysis; dialysis access; interventional radiology; stent
    • Publication Date:
      Date Created: 20230825 Date Completed: 20241106 Latest Revision: 20241106
    • Publication Date:
      20241106
    • Accession Number:
      10.1177/11297298231193893
    • Accession Number:
      37622463