| Autor: |
van Vuuren TM; 1 Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.; 2 Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands., Kurstjens RL; 1 Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.; 2 Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands.; 3 Department of Obstetrics and Gynaecology, Haga Teaching Hospital, The Hague, the Netherlands., de Wolf MA; 1 Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.; 2 Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands.; 4 Department of Radiology, Maasstad Hospital, Rotterdam, the Netherlands., van Laanen JH; 1 Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands., Wittens CH; 1 Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.; 2 Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands.; 5 Department of Vascular Surgery, University Hospital RWTH Aachen, Aachen, Germany., de Graaf R; 6 Department of Radiology, Maastricht University Medical Centre, Maastricht, the Netherlands. |
| Abstrakt: |
Background Venous stenting with an endophlebectomy and arteriovenous fistula can be performed in patients with extensive post-thrombotic changes. However, these hybrid procedures can induce restenosis, sometimes requiring stent extension, into a single inflow vessel. This study investigates the effectiveness of stenting into a single inflow vessel. Methods All evaluated patients had temporary balloon occlusion of the arteriovenous fistula to evaluate venous flow into the stents. When stent inflow was deemed insufficient, AVF closure was postponed and additional stenting was performed. Patency rates and clinical outcomes were evaluated. Results Twenty-four (38%) of 64 patients had additional stenting. The primary, assisted primary and secondary patency were 60 %, 70% and 70% respectively. Villalta score reduced by 6.1 points ( p < 0.001), and venous clinical severity score by 2.7 points ( p = 0.034). Conclusion Stenting through the femoral confluence into a single inflow vessel is a feasible bailout option if primary hybrid intervention fails with relative high patency rates and clinical improvement. |
