Percutaneous transluminal stenting in treatment of central venous stenosis: analysis of 29 patients

doi:10.3877/cma.j.issn.2095-5782.2020.02.002

Abstract

Abstract:

Objective

TTo evaluate the effect of percutaneous transluminal stenting (PTS) in treatment of central venous stenosis (CVS).

Methods

Clinical data of 29 patients who were diagnosed as CVS, manifested by imaging examination, and treated by PTS were collected and reviewed retrospectively. Follow-up was performed at the first, third and sixth month after discharge. The imaging examination, clinical results, complications, and second treatment were reviewed.

Results

36 treatment of PTS were performed in the patients. The technical success rate was 97.2%, and clinical effective rate was 94.4%. A total of 48 stents were implanted, including 36 bare stents and 12 covered stents. There was no complication observed among these cases. After 3-38 months of follow-up, restenosis of the stent occurred in 10 patients after PTS, and re-intervention was performed. The restenosis rate of bare stent after PTS (45.8%) was significantly higher than that of covered stent (10.0%) (χ²=3.852, P=0.046). Moreover, the restenosis rate after PTS was 57.1% in patients with chronic renal failure (CRF) undergoing hemodialysis through autologous arteriovenous fistula, and 19.0% in non-CRF patients, with significant difference (χ2=5.256, P=0.022). Compared with patients with post-operative regular anticoagulant therapy, the restenosis rate of stent in patients without regular anticoagulant therapy was higher (26.67% vs 100%, χ2=8.311, P=0.004).

Conclusions

PTS was effective in treatment of patients who suffered with CVS.The restenosis rate when performed with covered stent was lower than that with bare stent; however, the restenosis rate following PTS was higher in patients with CRF receiving hemodialysis treatment. Moreover, post-operative regular anticoagulant therapy was critical.

Key words: Central venous stenosis, Percutaneous transluminal stenting, Restenosis, Anticoagulan

Hui Guo, Jiani Liu, Yongyu Zhang, Huitao Zhang, Jia'nan He, Hairun Gan, Ni Zhao, Pengfei Pang. Percutaneous transluminal stenting in treatment of central venous stenosis: analysis of 29 patients[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2020, 08(02): 108-113.

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