Objective To observe the efficacy of intervention for central venous stenosis (CVS) or central venous occlusion(CVO) in maintenance hemodialysis (MHD) patients, and to explore the risk factors for relapse after central venous (CV) recanalization. Method A total of 94 cases with CVS or CVO admitted to West China Hospital, Sichuan University between June 2015 and March 2020 were retrospectively studied. They were divided into non-relapse group (n=33) and relapse group(n=61) based on the primary patency in the 18 months after CV recanalization. The average follow-up period was 32.53±11.07 months. The technical success rate of CVO recanalization after CV intervention therapy, and the primary patency rate and secondary patency rate after CV recanalization were evaluated. Cox regression was used to analyze the risk factors for relapse after CV recanalization. Results ①Technical success rate of CVO recanalization after CV intervention therapy was 96.23%; ②After CV recanalization for 6, 12, 18 and 24 month, the primary patency rates were 91.50%, 58.50%, 30.90% and 10.60% respectively, and the secondary patency rates were 98.80%, 93.80%, 92.50% and 88.80% respectively; ③Cox regression showed that smaller original vascular diameter at the abnormal CV site (HR=0.81, 95% CI: 0.69～0.94, P=0.006), longer CV lesion (HR=1.06, 95% CI: 1.03～1.08, P<0.001), no stent inserted (HR=0.32, 95% CI: 0.21～0.50, P<0.001), and higher serum calcium (HR=4.35, 95% CI: 1.34～14.13, P=0.014) were the risk factors for relapse after CV recanalization; ④Rank-sum test revealed that the length of CV lesions was longer in stent group(n=60) than in non-stent group (n=34) (Z= -2.037, P=0.042). Conclusions Technical success rate of CVO recanalization after CV intervention therapy was high with controllable risks. Multiple intervention therapies can improve the secondary patency rate of CV recanalization. The smaller original diameter at the CV lesion site, longer CV lesion, and higher serum calcium were the risk factors for relapse after CV recanalization. Stent placement after recanalization of longer CV lesion can improve the primary patency rate.
XIONG Liang-Wei
,
CUI Tian-Lei
. The efficacy of intervention therapy for central venous lesions in hemodialysis patients [J]. Chinese Journal of Blood Purification, 2022
, 21(08)
: 608
-612
.
DOI: 10.3969/j.issn.1671-4091.2022.08.016
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