Endovascular treatments of vascular complications in hemodialysis patients

87 SUMMARY: Purpose: To assess the complications formed because of central venous catheters and arteriovenous fistula in hemodialysis patients and to assess the efficacy of endovascular interventions made to treat these complications. Materials and Methods: Fortyfour hemodialysis patients with different vascular complications were treated with interventional methods. Thirteen catheters were not placed properly. These catheters were revised under fluoroscopy using guidewires. tPA is used to treat 10 occluded central venouz catheters. Twenty patients with central venous stenosis are treated only by PTA. Eight patients' ten stenotic lesions were treated by 11 stents and PTA. The indications for stent placement were elastic recoils and refractory stenosis to PTA. Four dysfunctinal native arteriovenous fistula and one dysfunctional graft were treated by PTA. The occluded graft was also treated with tPA application along with PTA. Results: The technical successes were %100 in revising malpositioned catheters, %80 in tPA application for occluded catheters, %70 in central venous stenosis treated by PTA alone, %100 in central venous stenosis treated by both PTA and stents, %100 in PTA for arteriovenous fistula and graft. According to the life survival analysis of Kaplan Meier the primary patency rate after PTA for central venous stenosis; after PTA and stenting for central venous stenosis; after PTA for arteriovenous fistula and grafts at 6 months were respectively: %85.7±9.3, %50±17.6, %60±22. The secondary patency rate after PTA for central venous stenosis; after PTA and stenting for central venous stenosis; after PTA for arteriovenous fistula and grafts at 6 months were respectively: %40±13, %90±9, %60±22. Conclusion: in treatment of vascular complications in hemodialysis patients endovascular interventional therapies should be preferred, because they are not only minimal invasive, but also effective, cheap and reliable methods.