Use of PTFE stent grafts for hemodialysis-related central XXXX : intermediate-term results.

@entity1 @entity455 @entity4 @entity409 @entity432 @entity736 @entity5648
PURPOSE: To assess the safety and effectiveness of a @entity736 ( @entity736 ) encapsulated @entity5648 stents (Bard Peripheral Vascular, Tempe, AZ) for treatment of hemodialysis-related central @entity432 . MATERIALS AND METHODS: Study design was a single-center nonrandomized retrospective cohort of @entity1 from May 2004 to August 2009 for a total of 64 months. There were 14 @entity1 (mean age 60 years, range 50-83 years; 13 male, 1 female). All @entity1 had autogenous fistulas. All 14 @entity1 had central @entity432 and presented with clinical symptoms of the following: extremity swelling (14%, 2 of 14), extremity and face swelling (72%, 10 of 14), and face swelling/ @entity4 (14%, 2 of 14). There was evidence of @entity409 with decreased access flow in 36% (5 of 14) @entity1 . There were prior interventions or previous line placement at the site of the central @entity455 in all 14 @entity1 . Results were assessed by recurrence of clinical symptoms and function of the access circuit (National Kidney Foundation recommended criteria). RESULTS: Sixteen consecutive straight stent grafts were implanted in 14 @entity1 . Average treated lesion length was 5.0  cm (range, 0.9-7  cm). All 14 @entity1 had complete central @entity432 (100% stenosis). The central @entity432 were located as follows: right subclavian and brachiocephalic vein (21%, 3 of 14), right brachiocephalic vein (36%, 5 of 14), left brachiocephalic vein (36%, 5 of 14), and bilateral brachiocephalic vein (7%, 1 of 14). A total of 16 PTFE stent grafts were placed. Ten- or 12-mm-diameter PTFE stent grafts were placed. The average stent length was 6.1  cm (range, 4-8  cm). Technical (deployment), anatomic (<30% residual stenosis), clinical (resolution of symptoms), and hemodynamic (resolution of @entity409 ) success were 100%. At 3, 6, and 9  months, primary patency of the treated area and access circuit were 100% (14 of 14). CONCLUSIONS: This PTFE encapsulated stent graft demonstrates encouraging intermediate-term patency results for central vein occlusions. Further prospective studies with long-term assessment and larger @entity1 populations will be required.
