Work

The case against stenting the cannulation zone of dialysis access

Year: 2024

Type: article

Abstract: The indications for stent grafts (SG) placement within the dialysis vascular access include recurrent stenosis at the venous anastomosis of arteriovenous grafts, vessel rupture, pseudoaneurysm exclusion, and intra-stent stenosis. Controversy exists regarding the use of SGs within the cannulation zone due to the theoretical risks of increased infection and stent fracture. While prospective studies are lacking, several retrospective studies demonstrated the safety of SG use within the cannulation area. However, the short-term nature of these retrospective studies makes it challenging to draw any reasonable conclusions about SG's long-term safety profile. The presented case here showed that the accumulative exposure to needle injury during dialysis therapy was associated with fracturing the stent leading to life-threatening skin ulcerations that required immediate surgical intervention. Additionally, this case suggests that deploying SG within the cannulation segment should be reserved for those with poor survival and have exhausted other access options.

Source: Radiology Case Reports

DOI: 10.1016/j.radcr.2024.08.141

Authors: Ivana Boktor, Abduljalil Alragheb, Ahmed E. Ali, Ammar Almehmi

Institutions: University of Sharjah, Community Health Systems - Crestwood Medical Center, University of Alabama at Birmingham

Language: English

Topic: Central Venous Catheters and Hemodialysis

Subfield: Emergency Medical Services

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $550