Central vein stenosis or occlusion associated with cardiac rhythm management device leads in hemodialysis patients with ipsilateral arteriovenous access: a retrospective study of treatment using stents or stent-grafts

The Journal of Vascular Access
Theodore F SaadJeffrey Cicone

Abstract

Symptomatic central vein stenosis commonly occurs when cardiac rhythm management device (CRMD) leads are placed via the subclavian vein ipsilateral to arteriovenous (AV) hemodialysis (HD) access. The purposes of this study were to determine the outcomes, complications, and patency following stenting of CRMD lead-associated central vein stenosis or occlusion, and to determine the effect of stents on CRMD function. Fourteen HD patients with AV access and an ipsilateral CRMD were treated with stents for symptomatic central vein stenosis or occlusion following inadequate response to angioplasty from January 2005 to December 2009. Subsequent access interventions, complications, and outcomes were reviewed retrospectively. Cardiology records were examined to assess CRMD function. Treatment of stenosis or occlusion with angioplasty and stenting resulted in 100% procedural success and no complications. At 6 and 12 months, respectively, primary patency rates were 45.5% and 9.0%; primary-assisted patency rates were 90.9% and 80.0%; secondary patency rates were 100% and 90.0%. There were 42 repeat interventions performed in 12 patients; five received additional stents. The mean number of subsequent interventions was 3.2 per patient (2.1 pe...Continue Reading

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Citations

Apr 6, 2016·Texas Heart Institute Journal·Sanjay Mehra, Mihail Gabriel Chelu
Nov 14, 2017·Journal of Cardiovascular Electrophysiology·Olivier A WittePeter Paul H M Delnoy
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Mar 16, 2018·The Journal of Vascular Access·Afsha AurshinaEnrico Ascher

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