Abstract
Vascular stenosis is most often the culprit behind hemodialysis vascular access dysfunction, and although percutaneous transluminal angioplasty remains the gold standard treatment for vascular stenosis, over the past decade the use of stents as a treatment option has been on the rise. Aside from the 2 Food and Drug Administration-approved stent grafts for the treatment of venous graft anastomosis stenosis, use of all other stents in vascular access dysfunction is off-label. Kidney Disease Outcomes Quality Initiative recommends limiting stent use to specific conditions, such as elastic lesions and recurrent stenosis; otherwise, additional adapted indications are in procedure-related complications, such as grade 2 and 3 hematomas. Published reports have shown the potential use of stents in a variety of conditions leading to vascular access dysfunction, such as venous graft anastomosis stenosis, cephalic arch stenosis, central venous stenosis, dialysis access aneurysmal elimination, cardiac implantable electronic device-induced stenosis, and thrombosed arteriovenous grafts. Although further research is needed for many of these conditions, evidence for recommendations has been clear in some; for instance, we know now that stents should be avoided along cannulation sites and should not be used in eliminating dialysis access aneurysms. In this review article, we evaluate the available evidence for the use of stents in each of the aforementioned conditions leading to hemodialysis vascular access dysfunctions.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 453-458 |
| Number of pages | 6 |
| Journal | Advances in Chronic Kidney Disease |
| Volume | 22 |
| Issue number | 6 |
| DOIs | |
| State | Published - 2015 |
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Keywords
- Aneurysms
- Cephalic arch stenosis
- CIED
- Dialysis access dysfunction
- Stents
ASJC Scopus subject areas
- Nephrology
Cite this
The Role of Endovascular Stents in Dialysis Access Maintenance. / El Kassem, Mohamad; Alghamdi, Issam; Vazquez-Padron, Roberto I; Asif, Arif; Lenz, Oliver; Sanjar, Tina; Fayad, Fadi; Salman, Loay.
In: Advances in Chronic Kidney Disease, Vol. 22, No. 6, 2015, p. 453-458.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - The Role of Endovascular Stents in Dialysis Access Maintenance
AU - El Kassem, Mohamad
AU - Alghamdi, Issam
AU - Vazquez-Padron, Roberto I
AU - Asif, Arif
AU - Lenz, Oliver
AU - Sanjar, Tina
AU - Fayad, Fadi
AU - Salman, Loay
PY - 2015
Y1 - 2015
N2 - Vascular stenosis is most often the culprit behind hemodialysis vascular access dysfunction, and although percutaneous transluminal angioplasty remains the gold standard treatment for vascular stenosis, over the past decade the use of stents as a treatment option has been on the rise. Aside from the 2 Food and Drug Administration-approved stent grafts for the treatment of venous graft anastomosis stenosis, use of all other stents in vascular access dysfunction is off-label. Kidney Disease Outcomes Quality Initiative recommends limiting stent use to specific conditions, such as elastic lesions and recurrent stenosis; otherwise, additional adapted indications are in procedure-related complications, such as grade 2 and 3 hematomas. Published reports have shown the potential use of stents in a variety of conditions leading to vascular access dysfunction, such as venous graft anastomosis stenosis, cephalic arch stenosis, central venous stenosis, dialysis access aneurysmal elimination, cardiac implantable electronic device-induced stenosis, and thrombosed arteriovenous grafts. Although further research is needed for many of these conditions, evidence for recommendations has been clear in some; for instance, we know now that stents should be avoided along cannulation sites and should not be used in eliminating dialysis access aneurysms. In this review article, we evaluate the available evidence for the use of stents in each of the aforementioned conditions leading to hemodialysis vascular access dysfunctions.
AB - Vascular stenosis is most often the culprit behind hemodialysis vascular access dysfunction, and although percutaneous transluminal angioplasty remains the gold standard treatment for vascular stenosis, over the past decade the use of stents as a treatment option has been on the rise. Aside from the 2 Food and Drug Administration-approved stent grafts for the treatment of venous graft anastomosis stenosis, use of all other stents in vascular access dysfunction is off-label. Kidney Disease Outcomes Quality Initiative recommends limiting stent use to specific conditions, such as elastic lesions and recurrent stenosis; otherwise, additional adapted indications are in procedure-related complications, such as grade 2 and 3 hematomas. Published reports have shown the potential use of stents in a variety of conditions leading to vascular access dysfunction, such as venous graft anastomosis stenosis, cephalic arch stenosis, central venous stenosis, dialysis access aneurysmal elimination, cardiac implantable electronic device-induced stenosis, and thrombosed arteriovenous grafts. Although further research is needed for many of these conditions, evidence for recommendations has been clear in some; for instance, we know now that stents should be avoided along cannulation sites and should not be used in eliminating dialysis access aneurysms. In this review article, we evaluate the available evidence for the use of stents in each of the aforementioned conditions leading to hemodialysis vascular access dysfunctions.
KW - Aneurysms
KW - Cephalic arch stenosis
KW - CIED
KW - Dialysis access dysfunction
KW - Stents
UR - http://www.scopus.com/inward/record.url?scp=84983146799&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84983146799&partnerID=8YFLogxK
U2 - 10.1053/j.ackd.2015.02.001
DO - 10.1053/j.ackd.2015.02.001
M3 - Review article
C2 - 26524950
AN - SCOPUS:84983146799
VL - 22
SP - 453
EP - 458
JO - Advances in Chronic Kidney Disease
JF - Advances in Chronic Kidney Disease
SN - 1548-5595
IS - 6
ER -