Percutaneous transluminal angioplasty of an in-stent re-stenosis of the right subclavian vein in a dialysis patient
Loading Stack -
0 images remaining
High grade in-stent restenosis. There are multiple collateral veins filling in in this venogram.
Post balloon angioplasty - good lumen restoration and disappearance of collateral venous filling.
Central venous stenosis is a relatively common problem in patients on long term haemodialysis through an AV fistula in the upper limb and may be seen in up to 40% of patients.
The clinical presentation may vary - poor flow rates at dialysis needing longer hours of dialysis, limb swelling etc.
Interventional radiology offers a good option of management of such cases either by percutaneous transluminal balloon angioplasty or stent placement. Post stenting there is risk of instent restenosis due to high flows at the dialysis and at the AV fistula. In-stent restenosis can be treated by balloon angioplasty.
This case demonstrates the use of balloon angioplasty in treating an in-stent restenosis.
- 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, 55:237-242
- Vascular Access Work Group: Clinical practice guidelines for vascular access. Am J Kidney Dis 2006, 48(Suppl 1):S248-S273.