Antecubital perforating vein stent-grafting for radiocephalic arteriovenous fistula recovery: A case report

Semin Dial. 2023 Jul-Aug;36(4):348-351. doi: 10.1111/sdi.13158. Epub 2023 May 28.

Abstract

Stent-grafts have been increasingly used in hemodialysis arteriovenous accesses, particularly in recurrent stenosis or in cases of vein rupture after percutaneous transluminal angioplasty (PTA). Although they limit neointimal hyperplasia, stenosis development at stent edges remains a concern. Despite their advantages, they are seldom used on the forearm veins due to fracture risk associated with elbow motion and the potential to limit cannulation sites. This report presents a novel application of stent-grafts in salvaging a radio-cephalic arteriovenous fistula in an 84-year-old male to treat a single outflow path at the elbow through a stenosed antecubital perforating vein, after failed PTA. The vascular access remained patent 18 months after the procedure, with no need for additional treatments at this target lesion, even though a PTA was required for juxta-anastomotic stenosis. This report highlights a possible further use of covered stents in arteriovenous vascular accesses.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Arteriovenous Fistula* / complications
  • Arteriovenous Shunt, Surgical* / adverse effects
  • Constriction, Pathologic
  • Graft Occlusion, Vascular / diagnostic imaging
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / surgery
  • Humans
  • Male
  • Renal Dialysis / adverse effects
  • Retrospective Studies
  • Stents / adverse effects
  • Treatment Outcome
  • Vascular Patency