Stent grafts provided superior primary patency for central venous stenosis treatment in comparison with angioplasty and bare metal stent: A retrospective single center study on 70 hemodialysis patients

Pietro Quaretti, Francesco Galli, Lorenzo Paolo Moramarco, Riccardo Corti, Giovanni Leati, Ilaria Fiorina, Carmine Tinelli, Giovanni Montagna, Marcello Maestri

Research output: Contribution to journalArticle

Abstract

Purpose: To compare patency in dialysis patients following different endovascular treatment of symptomatic central venous stenosis. Materials and Methods: A 10-year retrospective evaluation in 70 patients (32 men) dialyzing through vascular access (33, 47%) and tunneled catheters (37, 53%) was made. Three cohorts were compared: angioplasty alone (22), bare metal stent (28), and stent graft (20). Patencies were described with Kaplan-Meier method, and Cox uni- and multivariate models were analyzed to find factors associated. Results: All patients had a favorable anatomical and clinical outcome. Restenosis occurred in 22 (31%) of 70 patients requiring 41 additional interventions; 34 of 70 patients died (median follow-up 19.4 months). Primary patency at 3, 6, 12, and 24 months was 100%, 100%, 100%, and 84% for stent graft versus 90%, 79%, 58%, and 43% for angioplasty (P =.014) versus 84%, 80%, 75%, and 46% for bare-metal stent (P =.062). The overall comparison was more favorable for stent graft (P =.020) when the sites of lesions were matched. Patencies for angioplasty and bare-metal stents were equivalent (P =.141). A lower risk of restenosis (hazard rate [HR] 0.20, confidence interval [CI] 0.06-0.7) and fewer reinterventions (P

Original languageEnglish
Pages (from-to)221-230
Number of pages10
JournalVascular and Endovascular Surgery
Volume50
Issue number4
DOIs
Publication statusPublished - 2016

Keywords

  • angioplasty
  • bare metal stent
  • central venous stenosis
  • hemodialysis
  • stent graft
  • superior vena cava syndrome
  • vascular access

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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