USE OF WALLSTENTS FOR HEMODIALYSIS ACCESS-RELATED VENOUS STENOSES ANDOCCLUSIONS UNTREATABLE WITH BALLOON ANGIOPLASTY

PURPOSE: To determine whether the Wallstent endoluminal prosthesis can be used to maintain patency of venous stenoses and occlusions related to hemodialysis access. MATERIALS AND METHODS: Wallstents were placed in 52 patients with 56 lesions, Thirty-two lesions were in central ve ins and 24 were in peripheral veins. Stents were placed immediately af ter failed angioplasty in 39 patients, because bf early restenosis aft er angioplasty in four, and for treatment of a lesion unsuitable for a ngioplasty in eight. The remaining five lesions were treated at the op erator's discretion after predilation. RESULTS: The procedural success rate was 96%. The cumulative primary patency rate was 46% at 6 months and 20% at 12 months; however, with repeat treatment, the cumulative assisted patency rate was 76% at 6 months and 33% at 12 months. Known causes of recurrence included intimal hyperplasia in or near the stent , stent slippage, and remote stenoses. Complications included two sten t migrations due to central line placement and one stent-related pseud oaneurysm. CONCLUSION: Wallstents are safe to deploy for dialysis acce ss. Wallstents are useful for treating lesions that fail angioplasty a nd catheter-related central venous occlusions.