Patency rates for angioplasty in the treatment of pacemaker-induced central venous stenosis in hemodialysis patients: Results of a multi-center study

Arif Asif, Loay Salman, Roger Carrillo, Juan D. Garisto, Gustavo Lopera, Urwa Barakat, Oliver Lenz, Alexander Yevzlin, Anil Agarwal, Florin Gadalean, Bharat Sachdeva, Tushar J. Vachharajani, Steven Wu, Ivan D. Maya, Ken Abreo

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

While hemodialysis access ligation has been used to manage pacemaker (PM) and implantable cardioverter-defibrillator (ICD) lead-induced central venous stenosis (CVS), percutaneous transluminal balloon angioplasty (PTA) has also been employed to manage this complication. The advantages of PTA include minimal invasiveness and preservation of arteriovenous access for hemodialysis therapy. In this multi-center study we report the patency rates for PTA to manage lead-induced CVS. Consecutive PM/ICD chronic hemodialysis patients with an arteriovenous access referred for signs and symptoms of CVS due to lead-induced CVS were included in this analysis. PTA was performed using the standard technique. Technical and clinical success was examined. Technical success was defined as the ability to successfully perform the procedure. Clinical success was defined as the ability to achieve amelioration of the signs and symptoms of CVS. Both primary and secondary patency rates were also analyzed. Twenty-eight consecutive patients underwent PTA procedure. Technical success was 95%. Postprocedure clinical success was achieved in 100% of the cases where the procedure was successful. The primary patency rates were 18% and 9% at 6 and 12 months, respectively. The secondary patency rates were 95%, 86%, and 73% at 6, 12, and 24 months, respectively. On average, 2.1 procedures/year were required to maintain secondary patency. There were no procedure-related complications. This study finds PTA to be a viable option in the management of PM/ICD lead-induced CVS. Additional studies with appropriate design and sample size are required to conclusively establish the role of PTA in the management of this problem.

Original languageEnglish
Pages (from-to)671-676
Number of pages6
JournalSeminars in Dialysis
Volume22
Issue number6
DOIs
StatePublished - Nov 1 2009

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Balloon Angioplasty
Angioplasty
Renal Dialysis
Pathologic Constriction
Implantable Defibrillators
Therapeutics
Signs and Symptoms
Sample Size
Ligation
Lead

ASJC Scopus subject areas

  • Nephrology

Cite this

Patency rates for angioplasty in the treatment of pacemaker-induced central venous stenosis in hemodialysis patients : Results of a multi-center study. / Asif, Arif; Salman, Loay; Carrillo, Roger; Garisto, Juan D.; Lopera, Gustavo; Barakat, Urwa; Lenz, Oliver; Yevzlin, Alexander; Agarwal, Anil; Gadalean, Florin; Sachdeva, Bharat; Vachharajani, Tushar J.; Wu, Steven; Maya, Ivan D.; Abreo, Ken.

In: Seminars in Dialysis, Vol. 22, No. 6, 01.11.2009, p. 671-676.

Research output: Contribution to journalArticle

Asif, A, Salman, L, Carrillo, R, Garisto, JD, Lopera, G, Barakat, U, Lenz, O, Yevzlin, A, Agarwal, A, Gadalean, F, Sachdeva, B, Vachharajani, TJ, Wu, S, Maya, ID & Abreo, K 2009, 'Patency rates for angioplasty in the treatment of pacemaker-induced central venous stenosis in hemodialysis patients: Results of a multi-center study', Seminars in Dialysis, vol. 22, no. 6, pp. 671-676. https://doi.org/10.1111/j.1525-139X.2009.00636.x
Asif, Arif ; Salman, Loay ; Carrillo, Roger ; Garisto, Juan D. ; Lopera, Gustavo ; Barakat, Urwa ; Lenz, Oliver ; Yevzlin, Alexander ; Agarwal, Anil ; Gadalean, Florin ; Sachdeva, Bharat ; Vachharajani, Tushar J. ; Wu, Steven ; Maya, Ivan D. ; Abreo, Ken. / Patency rates for angioplasty in the treatment of pacemaker-induced central venous stenosis in hemodialysis patients : Results of a multi-center study. In: Seminars in Dialysis. 2009 ; Vol. 22, No. 6. pp. 671-676.
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