Authors: Philip Chonghei Kwok Kim Ming Wong Roger Kaicheong Ngan Susan Chihum Chan Wong Kan Wong Ka Yan Wong Andrew Kuiman Wong Ka Foon Chau Chun Sang Li
Publish Date: 2001/10/17
Volume: 24, Issue: 6, Pages: 400-406
Abstract
This study was done to evaluate the outcome after brachytherapy BT given to prevent restenosis after stent insertion for central venous stenosis in patients with ipsilateral hemodialysis arteriovenous fistulas AVF Angioplasty and stenting were performed on 9 primary central venous stenoses in 8 patients with AVF followed by BT delivering Iridium192 radiation using an afterloading technique BT was also administered to three patients with five recurrent stenoses at the stent margins There was no residual stenosis after angioplasty and stenting Venographic followup 77644 days mean 272 days showed no restenosis in seven primary stenoses New strictures 45100 developed at the stent margin in six veins five patients Angioplasty or stenting was performed for five margin stenoses in three patients followed by a second BT Residual stenosis before BT was 030 In our venographic followup 140329 days mean 215 days three restenoses occurred 35100 All progressed to complete occlusion on later venographic followup irrespective of whether BT was given to the stent margin or not The mean primary and assisted primary patency of the central veins were 359 days and 639 days respectively Endovascular irradiation with a noncentering source does not prolong the patency after angioplasty and stenting of central venous stenosis in hemodialysis patients
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