Efficacy of Balloon Angioplasty in Patients with Central Venous Stenosis or Obstruction Resulting from Central Vein Catheter Placement

Abstract

Background: Prolonged catheter insertion in central veins of hemodialysis patients usually causes central venous stenosis (CVS). These patients present with upper limbs, head and neck, and chest edema or hemodialysis problems. This study was done to determine the clinical success of balloon angioplasty for the treatment of symptomatic CVS/obstruction. Materials and Methods: Sixty-one hemodialysis patients who underwent endovascular treatment for CVS enrolled in this cross-sectional study between January 2017 and July 2018 at our institute. Enrollment included 29 female and 32 male subjects with a mean age of 58.9 ± 9.9 (range: 33–78) years. Results: A total of 61 patients underwent interventions for endovascular treatment of central venous disease. 38 out of 61 patients completed all three phases of the study (the beginning, after 3 and 6 months). The average diameter of central vein in venography at the beginning of the study, 3 and 6 months later were 8.66 mm, 8.03 mm, and 7.66 mm, respectively. The average patency was 45%, and 54% and 51% at the beginning of the study, 3 and 6 months after the treatment, respectively. There was an increase in central vein patency after 3 months of treatment, with significant difference among 3 phases (P < 0.000). Conclusion: Endovascular treatment is effective and safe for patients with central vascular stenosis with less complication rate compared to open surgical treatments, and the rate of venous patency in the treated veins with balloon angioplasty after 3 months is excellent, but this rate after 6 months is significantly reduced.

Keywords

• balloon angioplasty
• central venous catheter
• endovascular procedure
• hemodialysis
• venography