Chulalongkorn Medical Journal


Problem/background : The incidence of patients with end-stage renal disease (ESRD)has been increasing and the complications related to hemodialysisvascular access is the cause of prolonged hospitalization.The most common complication after vascular access is venousthrombosis. There are two effectively interventional treatmentprocedures of central venous obstruction; (1) Percutaneoustransluminal angioplasty (PTA) and (2) endovascular stentplacement.Objective : This research was performed to describe angiographic imagingof hemodialysis-related central venous obstruction, both beforeand after endovascular treatment and the outcomes andcomplications of endovascular treatment in patients withhemodialysis-related central venous obstruction.Design : Descriptive study.Setting : Department of Radiology, Faculty of Medicine, ChulalongkornUniversity.Material and Methods : A retrospective review of 53 digital subtraction angiographicstudies (DSA) was performed on 32 patients with hemodialysisrelatedcentral venous obstruction at King ChulalongkornMemorial Hospital from 2006 to 2010.Result : Central venous obstruction can occur anywhere along the venousoutflow tract. The PTA was performed in all cases and stent wasdeployed in 59% (19/31). Almost of the cases are technicalsuccessful after PTA and or stent placement in 96.8% (31/32).The only one patient was unsuccessful angioplasty due todifficult perform vascular access. The most lately outcome isre-stenosis in all cases. The overall primary patency ofthe endovascular treatment is in range of 2 months to 24 months.Conclusion : PTA with or without stent placement appear to be the standardtreatment of hemodialysis related central venous obstruction inESRD in KCMH. Most of the patients received successfullyinterventional treatment without immediate complication.The most common lately outcome after PTA with or without stenttreatment is re-stenosis in the obstructed site.


Faculty of Medicine, Chulalongkorn University

First Page


Last Page