Access-related venous stenoses and occlusions: Treatment with percutaneoustransluminal angioplasty and dacron-covered stents

Purpose: To determine the effectiveness of using Dacron-covered stents to t reat access-related venous stenoses and occlusions. Methods: Twenty-two Dacron-covered stents were placed in 20 patients: in th e basilic or axillary vein (n = 2), cephalic vein (n = 3), subclavian vein (n = 5), and at the venous anastomosis of the polytetrafluoroethylene (PTFE ) implant graft (n = 10). Results. Initial technical success was 100%. The cumulative primary and sec ondary patency rates were 57% and 83% at 6 months, 29% and 64% at 12 months , and 29% and 53% at 18 months. A statistically significant difference in t he stent patency was revealed by comparing the patients with stents in the subclavian vein and patients with upper arm stents. The secondary patency r ates of the upper arm stents were 73% after 6, 12, and 18 months. Conclusions: Percutaneous placement of Dacron-covered stents is a safe and effective procedure for salvage of a dialysis fistula. First results are pr omising, with a tendency to prolongation of the time interval between reint erventions.