MANAGEMENT OF SUPERIOR CENTRAL VEINS STEN OSIS WITH PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY IN HEMODIALYZED PATIENTS - RESULTS AND EVOLUTION

Stenosis and thrombosis of superior central veins are common complicat ions that compromise the viability of the vascular access in patients on maintenance hemodialysis. Percutaneous transluminal angioplasty has been succesfully used to treat stenosis in arterial or venous territo ries. We present our experience with angioplasty in 8 hemodialyzed pat ients who showed severe stenosis of the superior central veins. All pa tients had catheters implanted for dialysis in the affected veins and the steniosis coincided with the side of the vascular access in 6 pati ents. The diagnosis of superior central veins stenosis was suspected b y clinical signs (edema of the arm and/or presence of colateral circul ation) or increase of venous pressure during HD, and was confirmed by digital intravenous angiography (DIVAS). Angioplasty was initially suc cesful in 7 patients, without complication during the procedure. Howev er signs of stenosis reappeared in 4 patients during 9 months' follow- up, and the DIVAS confirmed the recurrence of the stenosis in 6 patien ts (85.7 %). Our results confirm that angioplasty it is a safe and suc cessful technique in the management of superior central vein stenosis in HD patients. However the longterm results are poor because of the h igh frequency of restenosis.