Percutaneous Transluminal Angioplasty and Stent Insertion in Central Venous Steno-occlusion

ABSTRACT

PURPOSE: To evaluate the efficacy of percutaneous transluminal angioplasty (PTA) and stent insertion incentral venous steno-occlusion. MATERIALS AND METHODS: Between August 1992 and January 1998, 11 patients with symptomatic central venous steno-occlusion(six stenoses and five occlusions) underwent pereutaneous treatment. Eleven PTAs were performed and stents were introduced in two patients because of incomplete PTA. During follow-up, a total of eight revisions were performed in five patients with recurrence(six stenoses and two occlusions). Success and long term patency rates were evaluated. The length and degree of the lesion and degree of residualstenosis, as well as pressure gradient through the lesion and decrease of the gradient after PTA, were correlated with patency rates. Complications during the procedures and follow-up period were evaluated. RESULT: The overall success rate was 89.5%; those of primary and revision intervention were 90.9% and 87.5%, respectively. Primary and revision patency rates were 72.7% and 50%, respectively, at 6 months, and 40% and 25% at 12 months. In five patients who underwent revision, primary and secondary patency rates were 80% and 100% at 6 months, 40% and 80% at 12 months, and 0% and 60% at 18 months. Only reduction of the pressure gradient after PTA correlated significantly with patency rates. No significant complications observed during the procedures follow-up period. CONCLUSION: PTA and stent insertion is effective for the treatment of central venous steno-occlusion.