Long-term outcome of stenting for the iliac vein stenosis with ipsilateral arterio-venous graft; a case series

Abstract

Abstract Objective To analyze the possible etiology and evaluate the technical and clinical outcomes of using bare metal stents for the treatment of central venous stenosis (CVS) in the lower extremity with ipsilateral hemodialysis access. Methods A single-center retrospective analysis of a small case series was conducted in hemodialysis patients with lower extremity arteriovenous grafts (AVG) who were treated with bare metal stents (BMS) for symptomatic iliac vein stenosis between April 2016 and June 2021. Patients’ demographic data, technical details, adverse events, clinical outcomes, and imaging data were recorded. Results The study cohort comprised seven females and four males, with a mean age of 58.8 ± 13.4 years. Preoperative lower limb venography was performed in nine patients scheduled for AVG creation. With the exception of one case demonstrating left iliac vein compression, the iliac veins were patent in all other patients. Symptoms of lower limb swelling developed at a mean interval of 9.40 ± 5.83 months (range: 3–20 months) following AVG placement. Eight cases had a concomitant history of temporary ipsilateral femoral vein catheterization. Lesion characteristics included nine stenotic lesions and two occlusive lesions. All patients were treated with SMART Control stents (Cordis Corp, USA). The technical success rate was 100%, and symptomatic relief was achieved in all cases. Over a mean follow-up period of 47.8 ± 31.7 months (range: 10–123 months), the target lesion primary patency was 100% (one-side confidence interval [CI] = 0.74,1). Conclusions Using BMS is a safe and effective method to treat iliac vein stenosis with ipsilateral AVG.