Diagnosis and Treatment of Insufficient Dialysis Vascular Access

 

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Abstract

A wide variety of diagnostic and minimally invasive modalities is currently available to radiologists for providing sufficient medical care for dialysis patients. In addition to clinical examination, ultrasound is the first line imaging method in suspected dialysis vascular access dysfunction. The percutaneous approach is the primarily recommended therapeutic option in many cases. This article reviews the current diagnostic and therapeutic methods in dialysis vascular access insufficiency.

Key Points:

• Vascular access dysfunction is often elicited by stenosed vessels, which are regularly associated with concomitant thrombosis.

• Stenoses are commonly observed in the anastomosis, vascular access vein and also in the central venous system.

• Beside the clinical examination, sonography is the diagnostic method of first choice.

• Percutaneous balloon dilatation frequently is the first treatment option.

Citation Format:

• Kamper L, Faizy TD, Haage P. Diagnosis and Treatment of Insufficient Dialysis Vascular Access. Fortschr Röntgenstr 2015; 187: 360 – 371

Zusammenfassung

Zur adäquaten medizinischen Betreuung des Dialysepatienten stehen dem Radiologen heute eine Vielzahl von diagnostischen und minimalinvasiven Methoden zur Verfügung. Neben der klinischen Untersuchung ist die Sonografie die bildgebende Methode der ersten Wahl bei vermuteter Dialyseshuntdysfunktion. Therapeutisch stellt die perkutane Behandlung oftmals die primär empfohlene Option dar. Die vorliegende Arbeit gibt einen Überblick über den derzeitigen Stand diagnostischer und therapeutischer Verfahren bei Malfunktion des Dialyseshunts.

• References

• 1 Gilg J, Rao A, Fogarty D. UK Renal Registry 16th Annual Report: Chapter 1 UK Renal Replacement Therapy Incidence in 2012: National and Centre-specific Analyses. Nephron Clin Pract 2013; 125: 1-27
  CrossrefPubMedGoogle Scholar
• 2 Bray BD, Boyd J, Daly C et al. Vascular access type and risk of mortality in a national prospective cohort of haemodialysis patients. QJM Mon J Assoc Physicians 2012; 105: 1097-1103
  PubMedGoogle Scholar
• 3 Stolic R. Most Important Chronic Complications of Arteriovenous Fistulas for Hemodialysis. Med Princ Pract 2013; 22: 220-228
  CrossrefPubMedGoogle Scholar
• 4 Mickley V. Stenosis and thrombosis in haemodialysis fistulae and grafts: the surgeon’s point of view. Nephrol Dial Transplant 2004; 19: 309-311
  CrossrefPubMedGoogle Scholar
• 5 Sivanesan S, How TV, Bakran A. Sites of stenosis in AV fistulae for haemodialysis access. Nephrol Dial Transplant 1999; 14: 118-120
  CrossrefPubMedGoogle Scholar
• 6 Mansour M, Kamper L, Altenburg A et al. Radiological central vein treatment in vascular access. J Vasc Access 2008; 9: 85-101
  PubMedGoogle Scholar
• 7 Kamper L, Haage P. Endovaskuläre Verfahren. In: Hepp W, Koch M, Konner K, (Hrsg.) Dialyseshunts. 2. Aufl. Darmstadt: Steinkopff; 2009
  CrossrefGoogle Scholar
• 8 Tattersall J, Martin-Malo A, Pedrini L et al. EBPG guideline on dialysis strategies. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc – Eur Ren Assoc 2007; 22: ii5-21
  PubMedGoogle Scholar
• 9 Kamper L, Frahnert M, Grebe S-O et al. Radiological assessment of vascular access in haemodialysis patients. J Vasc Access 2014; 15: 33-37
  PubMedGoogle Scholar
• 10 Guiu B, Loffroy R, Ben SalemD et al. Angioplasty of long venous stenoses in hemodialysis access: at last an indication for cutting balloon?. J Vasc Interv Radiol 2007; 18: 994-1000
  CrossrefPubMedGoogle Scholar
• 11 Vesely TM, Siegel JB. Use of the peripheral cutting balloon to treat hemodialysis-related stenoses. J Vasc Interv Radiol 2005; 16: 1593-1603
  CrossrefPubMedGoogle Scholar
• 12 Katsanos K, Karnabatidis D, Kitrou P et al. Paclitaxel-coated balloon angioplasty vs. plain balloon dilation for the treatment of failing dialysis access: 6-month interim results from a prospective randomized controlled trial. J Endovasc Ther Off J Int Soc Endovasc Spec 2012; 19: 263-272
  PubMedGoogle Scholar
• 13 Patanè D, Giuffrida S, Morale W et al. Drug-eluting balloon for the treatment of failing hemodialytic radiocephalic arteriovenous fistulas: our experience in the treatment of juxta-anastomotic stenoses. J Vasc Access 2012; DOI: 10.5301/jva.5000211.
  PubMedGoogle Scholar
• 14 Ahmed S, Roy-Chaudhury P. Radiation Therapy for Dialysis Access Stenosis: Unfulfilled Promise or False Expectations. Semin Dial 2012; 25: 464-469
  CrossrefPubMedGoogle Scholar
• 15 Misra S, Bonan R, Pflederer T et al. BRAVO I: A pilot study of vascular brachytherapy in polytetrafluoroethylene dialysis access grafts. Kidney Int 2006; 70: 2006-2013
  CrossrefPubMedGoogle Scholar
• 16 Rifkin BS, Brewster UC, Aruny JE et al. Percutaneous balloon cryoplasty: a new therapy for rapidly recurrent anastomotic venous stenoses of hemodialysis grafts?. Am J Kidney Dis Off J Natl Kidney Found 2005; 45: e27-32
  CrossrefPubMedGoogle Scholar
• 17 Truong TH, Spuentrup E, Staatz G et al. Mechanical thrombectomy of iliocaval thrombosis using a protective expandable sheath. Cardiovasc Intervent Radiol 2004; 27: 254-258
  PubMedGoogle Scholar
• 18 Kakkos SK, Haddad GK, Haddad J et al. Percutaneous rheolytic thrombectomy for thrombosed autogenous fistulae and prosthetic arteriovenous grafts: outcome after aggressive surveillance and endovascular management. J Endovasc Ther Off J Int Soc Endovasc Spec 2008; 15: 91-102
  PubMedGoogle Scholar
• 19 Lee T, Mokrzycki M, Moist L et al. Standardized definitions for hemodialysis vascular access. Semin Dial 2011; 24: 515-524
  CrossrefPubMedGoogle Scholar
• 20 Sidawy AN. , Society for Vascular Surgery. Arteriovenous hemodialysis access: the Society for Vascular Surgery practice guidelines. J Vasc Surg 2008; 48: 1S
  PubMedGoogle Scholar
• 21 Tordoir J, Canaud B, Haage P et al. EBPG on Vascular Access. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc – Eur Ren Assoc 2007; 22: ii88-117
  PubMedGoogle Scholar
• 22 Vascular Access Work Group. Clinical practice guidelines for vascular access. Am J Kidney Dis Off J Natl Kidney Found 2006; 48: S248-S273
  CrossrefPubMedGoogle Scholar
• 23 III. NKF-K/DOQI Clinical Practice Guidelines for Vascular Access: update 2000. Am J Kidney Dis Off J Natl Kidney Found 2001; 37: S137-S181
  CrossrefPubMedGoogle Scholar
• 24 Robbin ML, Chamberlain NE, Lockhart ME et al. Hemodialysis arteriovenous fistula maturity: US evaluation. Radiology 2002; 225: 59-64
  CrossrefPubMedGoogle Scholar
• 25 Thalhammer C, Aschwanden M, Staub D et al. Duplex sonography of hemodialysis access. Ultraschall in Med Stuttg Ger 1980 2007; 28: 450-465, quiz 466–471
  PubMedGoogle Scholar
• 26 Doelman C, Duijm LEM, Liem YS et al. Stenosis detection in failing hemodialysis access fistulas and grafts: comparison of color Doppler ultrasonography, contrast-enhanced magnetic resonance angiography, and digital subtraction angiography. J Vasc Surg 2005; 42: 739-746
  CrossrefPubMedGoogle Scholar
• 27 Ren J, Han X, Liu H et al. Ultrasonographic assessment of polytetrafluoroethylene upper extremity arteriovenous hemodialysis access: a retrospective analysis of 31 cases. Ther Apher Dial Off Peer-Rev J Int Soc Apher Jpn Soc Apher Jpn Soc Dial Ther 2012; 16: 548-553
  PubMedGoogle Scholar
• 28 Tordoir JH, Hoeneveld H, Eikelboom BC et al. The correlation between clinical and duplex ultrasound parameters and the development of complications in arterio-venous fistulae for haemodialysis. Eur J Vasc Surg 1990; 4: 179-184
  CrossrefPubMedGoogle Scholar
• 29 Older RA, Gizienski TA, Wilkowski MJ et al. Hemodialysis access stenosis: early detection with color Doppler US. Radiology 1998; 207: 161-164
  CrossrefPubMedGoogle Scholar
• 30 Malik J, Slavikova M, Svobodova J et al. Regular ultrasonographic screening significantly prolongs patency of PTFE grafts. Kidney Int 2005; 67: 1554-1558
  CrossrefPubMedGoogle Scholar
• 31 Amin MZ, Vesely TM, Pilgram T. Correlation of intragraft blood flow with characteristics of stenoses found during diagnostic fistulography. J Vasc Interv Radiol 2004; 15: 589-593
  CrossrefPubMedGoogle Scholar
• 32 Nassar GM, Ayus JC. Infectious complications of the hemodialysis access. Kidney Int 2001; 60: 1-13
  CrossrefPubMedGoogle Scholar
• 33 Schwarz C, Mitterbauer C, Boczula M et al. Flow monitoring: performance characteristics of ultrasound dilution versus color Doppler ultrasound compared with fistulography. Am J Kidney Dis Off J Natl Kidney Found 2003; 42: 539-545
  CrossrefPubMedGoogle Scholar
• 34 Wiese P, Nonnast-Daniel B. Colour Doppler ultrasound in dialysis access. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc – Eur Ren Assoc 2004; 19: 1956-1963
  PubMedGoogle Scholar
• 35 Dumars MC, Thompson WE, Bluth EI et al. Management of suspected hemodialysis graft dysfunction: usefulness of diagnostic US. Radiology 2002; 222: 103-107
  CrossrefPubMedGoogle Scholar
• 36 Kudlicka J, Kavan J, Tuka V et al. More precise diagnosis of access stenosis: ultrasonography versus angiography. J Vasc Access 2012; 13: 310-314
  CrossrefPubMedGoogle Scholar
• 37 Haage P, Vorwerk D, Piroth W et al. Treatment of hemodialysis-related central venous stenosis or occlusion: results of primary Wallstent placement and follow-up in 50 patients. Radiology 1999; 212: 175-180
  CrossrefPubMedGoogle Scholar
• 38 Duijm LEM, van der Rijt RHH, Cuypers PWM et al. Outpatient treatment of arterial inflow stenoses of dysfunctional hemodialysis access fistulas by retrograde venous access puncture and catheterization. J Vasc Surg 2008; 47: 591-598
  CrossrefPubMedGoogle Scholar
• 39 Asif A, Cherla G, Merrill D et al. Venous mapping using venography and the risk of radiocontrast-induced nephropathy. Semin Dial 2005; 18: 239-242
  CrossrefPubMedGoogle Scholar
• 40 Bucher AM, De Cecco CN, Schoepf UJ et al. Is Contrast Medium Osmolality a Causal Factor for Contrast-Induced Nephropathy?. BioMed Res Int 2014; 2014: e931413
  PubMedGoogle Scholar
• 41 Wessely R, Koppara T, Bradaric C et al. Choice of Contrast Medium in Patients With Impaired Renal Function Undergoing Percutaneous Coronary Intervention. Circ Cardiovasc Interv 2009; 2: 430-437
  CrossrefPubMedGoogle Scholar
• 42 Heye S, Maleux G, Marchal GJ. Upper-extremity venography: CO2 versus iodinated contrast material. Radiology 2006; 241: 291-297
  CrossrefPubMedGoogle Scholar
• 43 Kariya S, Tanigawa N, Kojima H et al. Efficacy of carbon dioxide for diagnosis and intervention in patients with failing hemodialysis access. Acta Radiol Stockh Swed 1987 2010; 51: 994-1001
  PubMedGoogle Scholar
• 44 Heverhagen J, Krombach G, Gizewski E. Application of Extracellular Gadolinium-based MRI Contrast Agents and the Risk of Nephrogenic Systemic Fibrosis. Fortschr Röntgenstr 2014; 186: 661-669
  Article in Thieme ConnectPubMedGoogle Scholar
• 45 Lehmkuhl L, Foldyna B, Haensig M et al. Role of preprocedural computed tomography in transcatheter aortic valve implantation. Fortschr Röntgenstr 2013; 185: 941-949
  Article in Thieme ConnectPubMedGoogle Scholar
• 46 Ye C, Mao Z, Rong S et al. Multislice computed tomographic angiography in evaluating dysfunction of the vascular access in hemodialysis patients. Nephron Clin Pract 2006; 104: c94-100
  CrossrefPubMedGoogle Scholar
• 47 Karadeli E, Tarhan NC, Ulu EMK et al. Evaluation of failing hemodialysis fistulas with multidetector CT angiography: comparison of different 3D planes. Eur J Radiol 2009; 69: 184-192
  CrossrefPubMedGoogle Scholar
• 48 Ko S-F, Huang C-C, Ng S-H et al. MDCT angiography for evaluation of the complete vascular tree of hemodialysis fistulas. Am J Roentgenol 2005; 185: 1268-1274
  CrossrefPubMedGoogle Scholar
• 49 Dimopoulou A, Raland H, Wikström B et al. MDCT angiography with 3D image reconstructions in the evaluation of failing arteriovenous fistulas and grafts in hemodialysis patients. Acta Radiol Stockh Swed 1987 2011; 52: 935-942
  PubMedGoogle Scholar
• 50 Wasinrat J, Siriapisith T, Thamtorawat S et al. 64-slice MDCT angiography of upper extremity in assessment of native hemodialysis access. Vasc Endovascular Surg 2011; 45: 69-77
  CrossrefPubMedGoogle Scholar
• 51 Heye S, Maleux G, Claes K et al. Stenosis detection in native hemodialysis fistulas with MDCT angiography. Am J Roentgenol 2009; 192: 1079-1084
  CrossrefPubMedGoogle Scholar
• 52 Rooijens PPGM, Serafino GP, Vroegindeweij D et al. Multi-slice computed tomographic angiography for stenosis detection in forearm hemodialysis arteriovenous fistulas. J Vasc Access 2008; 9: 278-284
  PubMedGoogle Scholar
• 53 Cansu A, Soyturk M, Ozturk MH et al. Diagnostic value of color Doppler ultrasonography and MDCT angiography in complications of hemodialysis fistulas and grafts. Eur J Radiol 2013; 82: 1436-1443
  CrossrefPubMedGoogle Scholar
• 54 Prince MR, Zhang HL, Prowda JC et al. Nephrogenic Systemic Fibrosis and Its Impact on Abdominal Imaging1. RadioGraphics 2009; 29: 1565-1574
  CrossrefPubMedGoogle Scholar
• 55 Thomsen HS, Morcos SK, Almén T et al. Nephrogenic systemic fibrosis and gadolinium-based contrast media: updated ESUR Contrast Medium Safety Committee guidelines. Eur Radiol 2013; 23: 307-318
  CrossrefPubMedGoogle Scholar
• 56 Martin DR, Krishnamoorthy SK, Kalb B et al. Decreased incidence of NSF in patients on dialysis after changing gadolinium contrast-enhanced MRI protocols. J Magn Reson Imaging 2010; 31: 440-446
  CrossrefPubMedGoogle Scholar
• 57 Amet S, Launay-Vacher V, Clément O et al. Incidence of Nephrogenic Systemic Fibrosis in Patients Undergoing Dialysis After Contrast-Enhanced Magnetic Resonance Imaging With Gadolinium-Based Contrast Agents: The Prospective Fibrose Nephrogénique Systémique Study. Invest Radiol 2014; 49: 109-115
  CrossrefPubMedGoogle Scholar
• 58 Becker S, Walter S, Witzke O et al. Application of Gadolinium-Based Contrast Agents and Prevalence of Nephrogenic Systemic Fibrosis in a Cohort of End-Stage Renal Disease Patients on Hemodialysis. Nephron Clin Pract 2012; 121: c91-c94
  CrossrefPubMedGoogle Scholar
• 59 Morcos SK. Dialysis and Contrast Media. In: Thomsen HS, Webb JAW, (Hrsg.). Contrast Media. Berlin Heidelberg: Springer; 2014: 105-109
  CrossrefGoogle Scholar
• 60 Bode AS, Planken RN, Merkx MAG et al. Feasibility of non-contrast-enhanced magnetic resonance angiography for imaging upper extremity vasculature prior to vascular access creation. Eur J Vasc Endovasc Surg Off J Eur Soc Vasc Surg 2012; 43: 88-94
  CrossrefPubMedGoogle Scholar
• 61 Turmel-Rodrigues L, Pengloan J, Bourquelot P. Interventional radiology in hemodialysis fistulae and grafts: a multidisciplinary approach. Cardiovasc Intervent Radiol 2002; 25: 3-16
  CrossrefPubMedGoogle Scholar
• 62 Vorwerk D, Guenther RW, Mann H et al. Venous stenosis and occlusion in hemodialysis shunts: follow-up results of stent placement in 65 patients. Radiology 1995; 195: 140-146
  CrossrefPubMedGoogle Scholar
• 63 Vorwerk D, Bücker A, Alzen G et al. Chronic venous occlusions in haemodialysis shunts: efficacy of percutaneous treatment. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc – Eur Ren Assoc 1995; 10: 1869-1873
  PubMedGoogle Scholar
• 64 Haage P, Vorwerk D. Dialysis Fistulas. In: Complex Cases Peripher. Vasc Interv. New York: Informa Healthcare; 2010: 239-256
  CrossrefGoogle Scholar
• 65 Mortamais J, Papillard M, Girouin N et al. Endovascular Treatment of Juxta-anastomotic Venous Stenoses of Forearm Radiocephalic Fistulas: Long-term Results and Prognostic Factors. J Vasc Interv Radiol 2013; 24: 558-564
  CrossrefPubMedGoogle Scholar
• 66 Turmel-Rodrigues L, Pengloan J, Blanchier D et al. Insufficient dialysis shunts: improved long-term patency rates with close hemodynamic monitoring, repeated percutaneous balloon angioplasty, and stent placement. Radiology 1993; 187: 273-278
  CrossrefPubMedGoogle Scholar
• 67 Turmel-Rodrigues L, Pengloan J, Baudin S et al. Treatment of stenosis and thrombosis in haemodialysis fistulas and grafts by interventional radiology. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc – Eur Ren Assoc 2000; 15: 2029-2036
  PubMedGoogle Scholar
• 68 Laird J, Jaff MR, Biamino G et al. Cryoplasty for the treatment of femoropopliteal arterial disease: results of a prospective, multicenter registry. J Vasc Interv Radiol 2005; 16: 1067-1073
  CrossrefPubMedGoogle Scholar
• 69 Cohen GS, Freeman H, Ringold MA et al. External beam irradiation as an adjunctive treatment in failing dialysis shunts. J Vasc Interv Radiol 2000; 11: 321-326
  CrossrefPubMedGoogle Scholar
• 70 Gorin DR, Perrino L, Potter DM et al. Ultrasound-guided angioplasty of autogenous arteriovenous fistulas in the office setting. J Vasc Surg 2012; 55: 1701-1705
  CrossrefPubMedGoogle Scholar
• 71 Ascher E, Hingorani A, Marks N. Duplex-guided balloon angioplasty of failing or nonmaturing arterio-venous fistulae for hemodialysis: a new office-based procedure. J Vasc Surg 2009; 50: 594-599
  CrossrefPubMedGoogle Scholar
• 72 Poulain F, Raynaud A, Bourquelot P et al. Local thrombolysis and thromboaspiration in the treatment of acutely thrombosed arteriovenous hemodialysis fistulas. Cardiovasc Intervent Radiol 1991; 14: 98-101
  CrossrefPubMedGoogle Scholar
• 73 Zaleski GX, Funaki B, Kenney S et al. Angioplasty and bolus urokinase infusion for the restoration of function in thrombosed Brescia-Cimino dialysis fistulas. J Vasc Interv Radiol 1999; 10: 129-136
  CrossrefPubMedGoogle Scholar
• 74 Turmel-Rodrigues L, Sapoval M, Pengloan J et al. Manual thromboaspiration and dilation of thrombosed dialysis access: mid-term results of a simple concept. J Vasc Interv Radiol 1997; 8: 813-824
  CrossrefPubMedGoogle Scholar
• 75 Liang H-L, Pan H-B, Chung H-M et al. Restoration of thrombosed Brescia-Cimino dialysis fistulas by using percutaneous transluminal angioplasty. Radiology 2002; 223: 339-344
  CrossrefPubMedGoogle Scholar
• 76 Yang CC, Yang CW, Wen SC et al. Comparisons of clinical outcomes for thrombectomy devices with different mechanisms in hemodialysis arteriovenous fistulas. Catheter Cardiovasc Interv 2012; 80: 1035-1041
  CrossrefPubMedGoogle Scholar
• 77 Dougherty MJ, Calligaro KD, Schindler N et al. Endovascular versus surgical treatment for thrombosed hemodialysis grafts: A prospective, randomized study. J Vasc Surg 1999; 30: 1016-1023
  CrossrefPubMedGoogle Scholar
• 78 Safa AA, Valji K, Roberts AC et al. Detection and treatment of dysfunctional hemodialysis access grafts: effect of a surveillance program on graft patency and the incidence of thrombosis. Radiology 1996; 199: 653-657
  CrossrefPubMedGoogle Scholar
• 79 Karnabatidis D, Kitrou P, Spiliopoulos S et al. Stent-grafts versus angioplasty and/or bare metal stents for failing arteriovenous grafts: a cross-over longitudinal study. J Nephrol 2013; 26: 389-395
  CrossrefPubMedGoogle Scholar
• 80 Haskal ZJ, Trerotola S, Dolmatch B et al. Stent graft versus balloon angioplasty for failing dialysis-access grafts. N Engl J Med 2010; 362: 494-503
  CrossrefPubMedGoogle Scholar
• 81 Prologo JD, Minwell G, Kent J et al. Effect of the time to intervention on the outcome of thrombosed dialysis access grafts managed percutaneously. Diagn Interv Radiol 2014; 20: 143-146
  PubMedGoogle Scholar
• 82 Kakisis JD, Avgerinos E, Giannakopoulos T et al. Balloon angioplasty vs nitinol stent placement in the treatment of venous anastomotic stenoses of hemodialysis grafts after surgical thrombectomy. J Vasc Surg 2012; 55: 472-478
  CrossrefPubMedGoogle Scholar
• 83 Aruny JE, Lewis CA, Cardella JF et al. Quality improvement guidelines for percutaneous management of the thrombosed or dysfunctional dialysis access. Standards of Practice Committee of the Society of Cardiovascular & Interventional Radiology. J Vasc Interv Radiol 1999; 10: 491-498
  PubMedGoogle Scholar
• 84 Trerotola SO, Vesely TM, Lund GB et al. Treatment of thrombosed hemodialysis access grafts: Arrow-Trerotola percutaneous thrombolytic device versus pulse-spray thrombolysis. Arrow-Trerotola Percutaneous Thrombolytic Device Clinical Trial. Radiology 1998; 206: 403-414
  CrossrefPubMedGoogle Scholar
• 85 Smits HFM, Smits JHM, Wüst AFJ et al. Percutaneous thrombolysis of thrombosed haemodialysis access grafts: comparison of three mechanical devices. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc – Eur Ren Assoc 2002; 17: 467-473
  PubMedGoogle Scholar
• 86 Mathias K, Jäger H, Willaschek J et al. Interventional radiology in central venous obstructions. Dilatation – stent implantation– thrombolysis. Radiol 1998; 38: 606-613
  CrossrefPubMedGoogle Scholar
• 87 Shi Y, Cheng J, Song Y et al. Anatomical factors associated with left innominate vein stenosis in hemodialysis patients. Hemodial Int Int Symp Home Hemodial 2014; DOI: 10.1111/hdi.12131.
  PubMedGoogle Scholar
• 88 Jaberi A, Schwartz D, Marticorena R et al. Risk factors for the development of cephalic arch stenosis. J Vasc Access 2007; 8: 287-295
  PubMedGoogle Scholar
• 89 Ozyer U, Harman A, Yildirim E et al. Long-term results of angioplasty and stent placement for treatment of central venous obstruction in 126 hemodialysis patients: a 10-year single-center experience. Am J Roentgenol 2009; 193: 1672-1679
  CrossrefPubMedGoogle Scholar
• 90 Shemesh D, Goldin I, Zaghal I et al. Angioplasty with stent graft versus bare stent for recurrent cephalic arch stenosis in autogenous arteriovenous access for hemodialysis: a prospective randomized clinical trial. J Vasc Surg 2008; 48: 1524-1531, 1531.e1–2
  CrossrefPubMedGoogle Scholar
• 91 Turmel-Rodrigues LAE. Regarding “Angioplasty with stent graft versus bare stent for recurrent cephalic arch stenosis in autogenous arteriovenous access for hemodialysis: A prospective randomized clinical trial”. J Vasc Surg 2009; 50: 472
  PubMedGoogle Scholar
• 92 Bhatia DS, Money SR, Ochsner JL et al. Comparison of surgical bypass and percutaneous balloon dilatation with primary stent placement in the treatment of central venous obstruction in the dialysis patient: one-year follow-up. Ann Vasc Surg 1996; 10: 452-455
  CrossrefPubMedGoogle Scholar
• 93 Mickley V, Görich J, Rilinger N et al. Stenting of central venous stenoses in hemodialysis patients: long-term results. Kidney Int 1997; 51: 277-280
  CrossrefPubMedGoogle Scholar

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