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Year 2020 Vol. 28 No 5

GENERAL & SPECIAL SURGERY

Z.B. KARDANAKHISHVILI 1, 2, A.B. ZULKARNAEV 1, V.V. ROGOZIN 3, V.A. STEPANOV 1

STENTING AND ISOLATED BALLOON ANGIOPLASTY FOR CENTRAL VENOUS STENOSIS IN PATIENTS UNDERGOING HEMODIALYSIS

Moscow Regional Research and Clinical Institute Named after M.F.Vladimirsky 1
M. E. Zhadkevich Moscow City Clinical Hospital of the Department of Health Care of Moscow 2
Moscow Hospital No2 for War Veterans of the Department of Health Care of Moscow 3, Moscow,
The Russian Federation

Objective. To carry out comparative analysis of the results of isolated balloon angioplasty (BA) and BA with stenting of the central venous stenosis (CVS) in patients undergoing hemodialysis .
Methods. A retrospective study included patients (n=62) with CVS. The isolated BA was performed in 39 patients. Stenting was added to isolated BA in 23 patients.
Results. Primary functional patency of the arteriovenous fistula after 1 and 3 years in the BA group was 89.7% [95%CI 74.9; 96] and 30.8% [95%CI 17.3; 45.4]; after stenting: 100% and 30.4% [95%CI 13.5; 49.3]; HR=0.8756 [95%CI 0.527; 1455], p=0.5994. Primary patency after 6 and 12 months in the BA group was 61.5% [95%CI 44.5; 74.7] and 15.4% [95%CI 6.2; 28.3]; after stenting: 82.6% [95%CI 60.1; 93.1] and 47.8% [95%CI 26.8; 66.1]; HR=0.4845 [95%CI 0.2938; 0.799], p=0.0017. Secondary functional patency after 1, 3 and 5 years in the BA group was 100%, 74.4% [95%CI 57.6; 85.3] and 12.8% [95%CI 4.7; 25.2]; after stenting: 100%, 91.3% [95%CI 69.5; 97.8] and 34.8% [95%CI 16.6; 53.7]; HR=0.4764 [95% CI 0.2888; 0.786], p=0.0016. Secondary patency after 6, 12 and 24 months in the BA group was 84.6% [95%CI 68.9; 92.8], 66.7% [95%CI 49.6; 79.1] and 17.9% [95%CI 7.9; 31.3]; after stenting: 91.3% [95%CI 69.5; 97.8], 78.3% [95%CI 55.4; 90.3] and 43.5% [95%CI 23.3; 62.1]; HR=0.4925 [95%CI 0.2988; 0.8119], p=0.0021. Correlation between primary functional patency and primary patency was r= -0.627; p<0.0001, between primary functional patency and secondary patency – r= -0.53; p=0.0005 in the BA group; after stenting: r= -0.351; p=0.101 and r= -0.304; p=0.159, respectively.
Conclusion. The results of BA significantly depend on the stage stenosis. The use of stenting can slightly improve the results regardless the CVS terms.

Keywords: vascular access, central veinous stenosis, hemodialysis, chronic kidney disease, endovascular surgery, balloon angioplasty, stenting
p. 515-526 of the original issue
References
  1. Mansour M, Kamper L, Altenburg A, Haage P. Radiological central vein treatment in vascular access. J Vasc Access. 2008 Apr-Jun;9(2):85-101. doi: 10.1177/112972980800900203
  2. Agarwal AK, Patel BM, Haddad NJ. Central vein stenosis: a nephrologist’s perspective. Semin Dial. 2007 Jan-Feb;20(1):53-62. doi: 10.1111/j.1525-139X.2007.00242.x
  3. Kundu S. Review of central venous disease in hemodialysis patients. J Vasc Interv Radiol. 2010 Jul;21(7):963-8. doi: 10.1016/j.jvir.2010.01.044
  4. ERA-EDTA Registry: ERA-EDTA Registry Annual Report 2015. Academic Medical Center, Department of Medical Informatics [Internet]. Amsterdam, the Netherlands; 2017. 146 р. Available from: https://www.era-edta-reg.org/files/annualreports/pdf/AnnRep2015.pdf
  5. Vatazin AV, Zulkarnaev AB, Fominykh NM, Kardanakhishvili ZB, Strugailo EV. The creation and maintenance of vascular access for chronic hemodialysis in the Moscow region: a five-year experience of a regional center.Russian Journal of Transplantology and Artificial Organs. 2018;20(4):44-53. doi: 10.15825/1995-1191-2018-4-44-53 (In Russ.)
  6. Schwab SJ, Quarles LD, Middleton JP, Cohan RH, Saeed M, Dennis VW. Hemodialysis-associated subclavian vein stenosis. Kidney Int. 1988 Jun;33(6):1156-59. doi: 10.1038/ki.1988.124
  7. Kouvelos GN, Spanos K, Antoniou GA, Vassilopoulos I, Karathanos C, Matsagkas MI, Giannoukas AD. Balloon angioplasty versus stenting for the treatment of failing arteriovenous grafts: a meta-analysis. Eur J Vasc Endovasc Surg. 2018 Feb;55(2):249-256. doi: 10.1016/j.ejvs.2017.11.011
  8. Schmidli J, Widmer MK, Basile C, de Donato G, Gallieni M, Gibbons CP, Haage P, Hamilton G, Hedin U, Kamper L, Lazarides MK, Lindsey B, Mestres G, Pegoraro M, Roy J, Setacci C, Shemesh D, Tordoir JHM, van Loon M, Esvs Guidelines Committee, Kolh P, de Borst GJ, Chakfe N, Debus S, Hinchliffe R, Kakkos S, Koncar I, Lindholt J, Naylor R, Vega de Ceniga M, Vermassen F, Verzini F, Esvs Guidelines Reviewers, Mohaupt M, Ricco JB, Roca-Tey R. Editor’s Choice – Vascular Access: 2018 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2018 Jun;55(6):757-18. doi: 10.1016/j.ejvs.2018.02.001
  9. Agarwal AK. Central vein stenosis. Am J Kidney Dis. 2013 Jun;61(6):1001-15. doi: 10.1053/j.ajkd.2012.10.024
  10. Stern AB, Klemmer PJ. High-output heart failure secondary to arteriovenous fistula. Hemodial Int. 2011 Jan;15(1):104-7. doi: 10.1111/j.1542-4758.2010.00518.x
  11. Browne LD, Bashar K, Griffin P, Kavanagh EG, Walsh SR, Walsh MT. The Role of Shear Stress in Arteriovenous Fistula Maturation and Failure: A Systematic Review. PLoS One. 2015 Dec 30;10(12):e0145795. doi: 10.1371/journal.pone.0145795. eCollection 2015.
  12. Oguzkurt L, Tercan F, Yildirim S, Torun D. Central venous stenosis in haemodialysis patients without a previous history of catheter placement. Eur J Radiol. 2005 Aug;55(2):237-42. doi: 10.1016/j.ejrad.2004.11.006
  13. Haskal ZJ, Saad TF, Hoggard JG, Cooper RI, Lipkowitz GS, Gerges A, Ross JR, Pflederer TA, Mietling SW. Prospective, randomized, concurrently-controlled study of a stent graft versus balloon angioplasty for treatment of arteriovenous access graft stenosis: 2-year results of the RENOVA study. J Vasc Interv Radiol. 2016 Aug;27(8):1105-14.e3. doi: 10.1016/j.jvir.2016.05.019
  14. Khawaja AZ, Cassidy DB, Al Shakarchi J, McGrogan DG, Inston NG, Jones RG. Systematic review of drug eluting balloon angioplasty for arteriovenous haemodialysis access stenosis. J Vasc Access. 2016 Mar-Apr;17(2):103-10. doi: 10.5301/jva.5000508
  15. Hongsakul K, Bannangkoon K, Rookkapan S, Boonsrirat U, Kritpracha B. Paclitaxel-coated balloon angioplasty for early restenosis of central veins in hemodialysis patients: a single center initial experience. Korean J Radiol. 2018 May-Jun;19(3):410-16. doi: 10.3348/kjr.2018.19.3.410
Address for correspondence:
129110, Russian Federation,
Moscow, Shchepkin str, 61/2, 6,
tel.: +7-916-705-98-99,
e-mail: 7059899@gmail.com,
Zulkarnaev Alexey B.
Information about the authors:
Kardanakhishvili Zurab B., Post-Graduate Student of the Department of Transplantation, Nephrology and Artificial Organs of the Faculty of Advanced Training, Moscow Regional Research and Clinical Institute named after M.F.Vladimirsky, Surgeon of the Department of Vascular Surgery, M. E. Zhadkevich Moscow City Clinical Hospital, Moscow, Russian Federation.
https://orcid.org/0000-0001-9739-6432
Zulkarnaev Alexey B., Leading Researcher, the Surgical Department of Kidney Transplantation, Moscow Regional Research and Clinical Institute Named after M.F.Vladimirsky, Moscow, Russian Federation.
https://0000-0001-5405-7887
Rogozin Vasily V., Surgeon of the Department of Vascular Surgery, Moscow Hospital No2 for War Veterans of the Department of Health Care of Moscow, Moscow, Russian Federation.
https://0000-0003-4870-6400
Stepanov Vadim A., Senior Researcher of the Surgical Department of Kidney Transplantation, Moscow Regional Research and Clinical Institute named after M.F.Vladimirsky, Moscow, Russian Federation.
https://0000-0002-0881-0599
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