vascular-surgery-2019-scientifictracks

16 / 25

Vascular Surgery 2019 Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482 Page 46
March 28-29, 2019
Rome, Italy
Vascular Surgery
4th Edition of World Congress & Exhibition on
Central venous occlusive disease in hemodialysis patients
– What to do when the dialysis fistula is quickly occluded
after reintervention?
E Swiecka, M Khaznadar, T Krönert and R Zippel
Elbe-Elster-Klinikum, Germany
E Swiecka et al., J Vasc Endovasc Therapy 2019, Volume 4
DOI: 10.21767/2573-4482-C1-005
Introduction: Recurrent or long-term central catheterization
could lead to central thoracic venous stenosis or occlusion.
The symptoms are a shunt/fistula dysfunction or occlusion
with visible collateral circuit on the skin and increased
venous pressure during hemodialysis.
Methods: We describe our diagnostic and therapeutic
strategy on five patients with thoracic central vein
stenoses treated in our hospital during the last 2 years. All
patients have a history of 5-10 years in hemodialysis and
underwent 2-4 fistula operations within the last 12 months.
A venous CT of the thoracic veins was indicated by all
patients after revascularization when the dialysis fistula
was quickly occluded. The CTs identified 4 occlusions
of the vena brachiocephalica and one of vena subclavia.
Moreover, two obstructions of vena cephalica as well
as one aneurysm of the fistula vein were detected. Four
patients were successfully operated with thrombectomy
and simultaneous implantation of relatively small-caliber
vein stents (8-12 mm diameter) in central position. One
had a percutaneous thrombectomy of thoracic veins with
thrombectomy system and stent application over the same
access.
Conclusions: In patients with recurrent occlusions
of arteriovenous access and a long-term history of
hemodialysis, a stenosis of the central veins can be
included. Already at the first sign of shunt dysfunction,
a diagnosis has to be made to avoid an acute occlusion
and the then often necessary implantation of a central
venous catheter. We recommend the one-time care with
thrombectomy and central venous stenting. Even after the
implantation of relatively small-caliber stents, we achieved
satisfactory results.
Biography
E Swiecka graduated from the Medical University in Gdansk, Poland. In
2004 she moved to Germany in order to practice medical profession.
She conducted her residency (stage practice) in vascular surgery in Au-
gusta Hospital in Düsseldorf under supervision of prof. R. Kolvenbach
and in DRK- Hospital in Berlin under Dr. MNaundorf. Between July 2014
and July 2017 she held a post of the Consultant of Vascular Surgery at
theMedical University of Brandenburg in Neuruppin, Germany. InMarch
2018 she took a post of the Senior Consultant at the Vascular and En-
dovascular Surgery Department in Elbe-Elster Klinikum in Herzberg,
Germany. She is a Member of many national and international medical
societies, including European Society for Vascular Surgery, Polish Vas-
cular Surgeon Society and Bulgarian Society of Vascular Surgery. As for
hands-on clinical experience, she specializes in carotid and dialysis sur-
gery as well as endovascular procedures.