Treatment of central venous in-stent restenosis with repeat stent deployment in hemodialysis patients.

Journal Article (Journal Article)

PURPOSE: To report patency rates for stent deployment for treatment of in-stent stenosis of the central veins of the chest in hemodialysis patients. MATERIALS AND METHODS: A retrospective analysis was performed on 29 patients who underwent 35 secondary percutaneous transluminal stent (PTS) deployments for in-stent stenosis within the central veins that were refractory to angioplasty and ipsilateral to a functioning hemodialysis access (in-stent PTS group). For comparison, patency data were acquired for 47 patients who underwent 78 successful percutaneous transluminal angioplasty (PTA) procedures for in-stent stenosis (in-stent PTA group) and 55 patients who underwent 55 stent deployments within native central vein stenosis refractory to angioplasty (native vein PTS group). RESULTS: The 3-, 6-, and 12-month primary lesion patency for the in-stent PTS group was 73%, 57%, and 32%, respectively. The 3-, 6-, and 12-month primary patency for the in-stent PTA group was 70%, 38%, and 17% and for the native vein PTS group was 78%, 57%, and 26%, which were similar to the in-stent PTS group (p = 0.20 and 0.41, respectively). The 3-, 6-, and 12-month secondary access patency was 91%, 73%, and 65% for the in-stent PTS group. Sub-analysis of the in-stent PTS group revealed no difference in primary (p = 0.93) or secondary patency rates (p = 0.27) of bare metal stents (n = 23) compared with stent grafts (n = 12). CONCLUSIONS: Stent deployment for central vein in-stent stenosis refractory to angioplasty was associated with reasonable patency rates, which were similar to in-stent PTA and native vein PTS.

Full Text

Duke Authors

Cited Authors

  • Ronald, J; Davis, B; Guevara, CJ; Pabon-Ramos, WM; Smith, TP; Kim, CY

Published Date

  • May 15, 2017

Published In

Volume / Issue

  • 18 / 3

Start / End Page

  • 214 - 219

PubMed ID

  • 28430317

Electronic International Standard Serial Number (EISSN)

  • 1724-6032

Digital Object Identifier (DOI)

  • 10.5301/jva.5000705


  • eng

Conference Location

  • United States