ORIGINAL ARTICLE   

Italian Journal of Vascular and Endovascular Surgery 2017 December;24(4):146-50

DOI: 10.23736/S1824-4777.17.01308-0

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Single versus dual access as endovascular techniques in the management of challenging central venous occlusive disease: success rate and efficacy

Ahmed R. TAWFIK ✉, Khadiga S. GAD EL-RAB

Department of Vascular Surgery, Kasr Ani Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt

BACKGROUND: Central venous occlusion and access dysfunction is a major complication for centrally inserted catheters. Endovascular intervention provides a suitable solution for such complication. The aim of this study was to evaluate, demonstrate different endovascular techniques in the management of central venous occlusion in chronic renal failure (CRF) patients.
METHODS: CRF patients who had symptomatic central venous occlusion underwent venography followed by percutaneous transluminal angioplasty using standard conventional technique or double wire flossing technique in challenging cases.
RESULTS: Twenty-one patients had central venous occlusion, in two cases the lesion extend to the superior vena cava. Flossing wire technique performed in 28.4%. Technical success rate was 95.23%.
CONCLUSIONS: Endovascular intervention is feasible with low complication rate. Wire flossing technique is a safe technique for challenging long chronic total occlusion central venous lesions where covered stents is not available for fear of fatal hemorrhagic complications.

KEY WORDS: Endovascular procedures - Angioplasty - Stents - Vascular access devices