Radiology, Vol 195, 140-146, Copyright © 1995 by Radiological Society of North America

ARTICLES

Venous stenosis and occlusion in hemodialysis shunts: follow-up results of stent placement in 65 patients

D Vorwerk, RW Guenther, H Mann, K Bohndorf, P Keulers, G Alzen, M Sohn and D Kistler
Department of Diagnostic Radiology, Technical University of Aachen, Germany.

PURPOSE: To provide follow-up data on the use of self-expanding stents in hemodialysis fistulas to improve the technical success of balloon angioplasty. MATERIALS AND METHODS: Ninety-two self-expanding vascular stents were placed in 65 patients (29 men and 36 women 25-79 years of age; mean, 57.6 years) with failing hemodialysis fistulas or shunts. RESULTS: Stent placement was successful in all patients, but rethrombosis of the shunt occurred in six patients (10%) within 1 week. There were 96 episodes of reobstruction. In 87 cases, percutaneous or combined surgical and percutaneous repeat intervention was performed. The cumulative shunt function rate was 88% after 6 months, 86% after 1 year, and 77% after 2 years. CONCLUSION: Stent placement in hemodialysis fistulas helps treat lesions that cannot be adequately treated with percutaneous transluminal angioplasty (PTA) alone but has a follow-up patency rate similar to that of PTA. Standard central venous stents have a better patency rate than after PTA.

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