Endovascular treatment of central thoracic venous stenosis and occlusion in hemodialysis patients

Aim: This study aims to present the endovascular treatment of symptomatic central venous stenosis or occlusion in patients with ipsilateral native arteriovenous fistula or graft. Material and methods: A total of 21 patients with central venous disease were reviewed retrospectively. The patients were referred with swelling in the arm, neck, or both and inadequate or unsuccessful dialysis sessions. The location, length, and extension of the stenosis/occlusion were evaluated by diagnostic venography and angioplasty with or without stenting was performed. The patients were monitored until the termination of follow-up, renal transplantation, complete loss of ipsilateral vascular access, or death. Results: The technical success rate was 90.5%. The mean follow-up period for the patients who received successful treatment was 12.53 months. The primary patency rates at 3, 6, and 12 months were 89.4%, 61.1%, and 50%, respectively. Discussion: Endovascular interventions performed in cases of central venous occlusion and stenosis are technically successful, safe, and effective in terms of short-term results. However, patients should be under close follow-up and be prepared for repetitive interventions due to low patency rates in the long term. To prevent the emergence of central venous pathologies, unnecessary, prolonged, and repetitive central venous catheterizations should be avoided.