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KMID : 0378120020290010175
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Chungnam Medical Journal
2002 Volume.29 No. 1 p.175 ~ p.183
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Hemodialysis associated Central Venous Stenosis in Chronic Renal Failure patients
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Lim Dae-Seung
Lee Jeong-Woo
Kang Jeong-A
Kim Jeong-Hee
Lee Min-Su
Jeong Jun-Young
Choi Si-Wan
Jung Jin-Ok
Sung In-Hwan
Lee Kang-Wook
Shin Young-Tai
No Sang-Pil
Lee Yeu-Seon
Jeong Seung-Hyeon
Kim Bo-Yeong
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Abstract
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Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.
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KEYWORD
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Central vein stenosis, Percutaneous transluminal angioplasty, Wallstent Placement
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