CRAGG COVERED STENTS IN HEMODIALYSIS ACCESS - INITIAL AND MIDTERM RESULTS

PURPOSE: To report midterm follow-up after implantation of covered ste nts for hemodialysis access. PATIENTS AND METHODS: Over a 2-year perio d, a Cragg Endopro stent was placed in 14 patients (mean age, 66.6 yea rs +/- 15) to treat angioplasty-induced ruptures (n = 3), pseudoaneury sm (n = 1), postangioplasty residual stenosis (n = 2), and early reste nosis (n = 8, four of them in a Wallstent). RESULTS: Initial placement was successful in all cases. A clinical inflammatory reaction was obs erved in all three cases of placement in the forearm. When the covered stent was placed in a stenotic vessel, restenosis always occurred wit hin 6 months. Primary and secondary patencies were 28.5% +/- 13.9 and 67.8% +/- 14.5, respectively, at 6 months, Covered stents were of undo ubtable benefit in one case of rupture after Wallstent failure and in one case of restenosis in a Wallstent. CONCLUSION: Covered Cragg stent s are effective in controlling angioplasty-induced rupture and sometim es for maintaining patency after restenosis in a Wallstent. They do no t prevent restenosis and are responsible for an inflammatory reaction of unknown origin and long-term effect.