Central Vein Stenosis in Patients with Central Vein Manipulation: A Single Center Experience

Abstract

Introduction: Central vein catheterization (CVC) is one of the main risk factors for central vein stenosis (CVS) occurrence in the hemodialysis population. In this work we aimed to evaluate previous central venous manipulation, clinical presentation, and complications in hemodialysis patients with proved CVS. Material and Methods: We retrospectively reviewed all venous angiographies in patients attending our public hospital center for hemodialysis treatment from 2013 to 2018 (n=209). In patients with confirmed CVS (n=29, 14%), we evaluated history of prior CVC and cardiac rhythm devices (CDR), as well as demographics and cardiovascular risk factors. Results: We identified 31 CVS in 29 patients who underwent venous angiography. Most of these patients, 75.9% (n=22), had at least one CVC (ipsilateral or not); at least one previous ipsilateral short-term CVC was found in 34.4% (n=10) of patients and at least one previous ipsilateral long-term CVC was found in 41.4% (n=12) of patients. All patients who had a prior CRD (n=4, 13.8%), had developed an ipsilateral CVS. Conclusion: Prevalence of detected CVS in our population was significant and is likely underestimated. A high percentage of patients with CVS had an history of previous ipsilateral CVC. The number of patients with previous short-term CVC was similar to that of previous long-term CVC, hinting an important role of short-term CVC as a risk factor do CVS.