PERCUTANEOUSLY INTRODUCED INTRAVASCULAR STENTS FOR TREATING OCCLUSION OR STENOSIS OF HEMODIALYSIS SHUNTS

In ten patients (four men and six women, mean age 51.7 [26-79] years), with six occlusions and five stenoses of a haemodialysis shunt or shunt-draining subclavian vein, a self-expanding intravascular stent was implanted percutaneously after balloon-dilatation. The implantation was succesfull in 9 of 11 instances, but the shunt thrombosed in two within 24 hours (in one of the patients, with antithrombin III deficiency, the shunt had to be abandoned). After an average observation period of 7.8 (1-14) months, ten shunts have remained open and suitable for dialysis. A further stent had to be implanted in one of the patients because of stenosis distal to the first stent. In three patients intima hyperphasia within the stent necessitated percutaneous balloon dilatation and/or atherectomy.