WALLSTENT DEPLOYMENT TO SALVAGE DIALYSIS GRAFT THROMBOLYSIS COMPLICATED BY VENOUS RUPTURE - EARLY AND INTERMEDIATE RESULTS

OBJECTIVE. The feasibility of deploying Wallstents to treat venous rup ture occurring during dialysis graft thrombolysis was determined. SUBJ ECTS AND METHODS. Between June 24, 1994, and February 19, 1997, 23 pat ients with venous rupture attributed to balloon angioplasty during dia lysis graft thrombolysis were treated by Wallstent deployment across t he area of rupture. Twenty-one ruptures occurred in peripheral veins a nd two occurred in central veins. Follow-up was provided by the clinic al service at our institution and by electronic review of patients' ch arts. RESULTS. Stent placement allowed completion of graft thrombolysi s in all 23 patients. Complications were limited to four moderate-size d hematomas of the arm, and a single pseudoaneurysm developed 6 months after stent placement in one 27-year-old patient. The primary patency rate of stents was 52% at 60 days, 26% at 180 days, and 11% at 360 da ys, The secondary patency rate was 74% at 60 days, 65% at 180 days, an d 56% at 360 days. CONCLUSION. Treatment of venous ruptures using Wall stents is a safe alternative to intentional graft thrombosis. The pate ncy rates of these devices are similar to those of venous stents place d for other indications.