The feasibility of transradial artery approach for angioplasty of central vein stenosis in hemodialysis patients

Purpose: To evaluate the feasibility of transradial (TR) intervention for central vein stenosis (CVS) in hemodialysis patients. Methods: This study retrospectively reviewed 41 consecutive TR endovascular procedures for CVS. Patient baseline characteristics and long-term outcomes were recorded and analyzed, and the primary patency rate was analyzed by the Kaplan-Meier method. Results: The 41 patients in our study consisted of 19 males and 22 females with a mean age of 62.812.1 years. There were 21 cases of right-sided CVS and 20 cases of left-sided CVS. Of the procedures performed, 12 were arteriovenous grafts and 29 were native arteriovenous fistulas. Initial fistulography revealed 14 occluded lesions (34.1%) and 27 stenotic lesions (65.9%). During intervention, thrombosis was found in 8 cases (19.5%) and CVS was combined with other lesions in 21 cases (51.2%). The TR approach achieved a technique success rate of 90.2%. Themedian primary patency time was 8.4months, and the primary patency rates at 3, 6, 9, and 12months were 81%, 64%, 57%, and 45%, respectively. There were no adverse events caused by radial artery occlusion. Conclusion: TR intervention is a feasible alternative to conventional intervention in selected CVS cases, particularly those combined with lesions located at arterio-venous or arterio-graft anastomotic areas (within 2 cmto anastomosis).