Central venous stenoses in AV fistula patients; sites and endovascular management

4^th International Conference on Kidney Failure & Renal Care

August 19, 2024 | Webinar

Khawaja Bilal Waheed

Saudi Arabia

Scientific Tracks Abstracts: J Nephrol Ther

Abstract :

Statement of the Problem: A properly functioning arteriovenous (AV) access is essential for the hemodialysis patient. The arteriovenous fistula is regarded as the vascular access of choice for hemodialysis (HD) because of its superior patency and lower complication rates. Unfortunately, AV access flow dysfunction is a common problem resulting from venous stenosis and, to a lesser degree, arterial stenosis. AV access stenosis contributes significantly to patient morbidity and increased medical costs. These problems are magnified when stenosis results in failure of the access due to thrombosis. We aim to evaluate sites of occurrence of stenosis after AV fistula formation and the role of endovascular management for such cases. Methodology & Theoretical Orientation: We performed a retrospective record-based study evaluating the development of stenosis in AV fistula patients who came to our Nephrology department over a period of the last 5 years. Type of AV fistula (brachiocephalic, brachiobasilic), and site of stenosis (juxta-anastomotic venous, peripheral venous, and central venous) were documented. Endovascular management (angioplasty alone or with stenting) for these patients was recorded. Recurrence of stenosis and course of management were also noted. Findings: Out of 13 AV fistulas (11 brachiocephalic, 2 brachiobasilic) patients aged between 35-63 years, 10 were on the left side. 9 cases were having central venous stenoses (3 with peripheral venous stenoses as well). 3/4 of the remaining were juxta-anastomotic. Angioplasty with stenting was performed in 6 of 12 cases, and the remaining 6 cases had only angioplasties (out of these 1 was failed angioplasty). Conclusion & Significance: Central or peripheral venous stenosis can occur in AV fistula patients, for which endovascular management is usually successful.

Biography :

Dr. Waheed is a senior consultant radiologist working at King Fahad Military Medical Complex (KFMMC) in Dhahran, Saudi Arabia. He has vast experience in diagnostic and interventional radiology and is actively involved in resident teaching and research