MANAGEMENT OF VENOUS HYPERTENSION IN THE UPPER LIMBS AS A COMPLICATION OF ARTERIO-VEOUS ACCESS FOR HAEMODIALYSIS

Abstract

Central venous occlusive disease (CVOD) remains a significant problem in the long-term management of hemodialysis patients.The correlation between Central venous catheterization use and central vein stenosis has been well documented.The most definitive but simultaneously drastic surgical remedy is ligation of the access.Endovascular intervention for hemodialysis-related Central venous occlusive disease remains the present mainstay of treatment.. PTA has shown variable technical success of 70% to 90% and variable 6- and 12-month patency rates.Bare metal stents are the second-generation technology and the second-line treatment of Central venous occlusive disease. Future treatments may include coated drug elutingstents with biologic active coating to improveendothelial healing inside the stent and limit neointimalhyperplasia. Central venous occlusive disease can be addressed through extra-anatomic bypass.

Key words: - catheter, venous, occlusion, hypertension, stent, bypass.