ENDOVASCULAR MANAGEMENT OF CENTRAL VEIN LESIONS IN PATIENTS WITH LONG TERM HEMO-DIALYSIS THROUGH UPPER LIMB ARTERIO-VENOUS FISTULA- A SINGLE CENTRE RETROSPECTIVE STUDY

Background: Central venous disease is a serious complication in patients undergoing hemodialysis, often presenting with symptoms of venous hypertension. Treatment is aimed to provide symptomatic relief and to maintain hemodialysis access site patency. Aim: To describe our initial experience in the endovascular treatment of central venous stenosis or obstruction in patients undergoing hemodialysis. Settings and Design: This was a retrospective study carried out in a tertiary care center. Study duration was 24 months. Follow up was variable. Materials and Methods: Fourteen patients of chronic renal failure undergoing hemodialysis presented with central vein stenosis or obstruction having ipsilateral vascular access, between January 2017 and December 2018. All the patients underwent endovascular treatment and were analyzed retrospectively. Results and Conclusion: A total of 14 patients (12 male and 2 female) underwent 18 interventions for 13 stenotic segments during a time period of 2 years. Ten stenotic segments were in brachiocephalic vein, four in subclavian vein. The technical success rate for endovascular treatment was 71.4%. All underwent percutaneous transluminal angioplasty (PTA) alone and four presented with restenosis later. Repeat Balloon angioplasty was done in four patients, two of which required >=2 reinterventions during follow up. We found endovascular treatment safe and effective in treating central venous disease.