Central Venous Occlusion Caused by a Collapsed Stent: Endovascular Treatment in an Emergency

Abstract

Background: Stenosis and central venous obstruction are very serious and frequent complications in hemodialysis patients. The incidence of these complications is 30% and is due to an increase in venous flow that generates inflammation and proliferation of the endothelium. Causes of acute venous occlusion have rarely been described and the endovascular therapeutic options include percutaneous transluminal angioplasty (PTA) with or without the placement of a stent. Methods: We report the clinical case of an acute occlusion of a covered stent in a right anonymous vein treated through a Bard Covera Plus recanalization and stent delivery procedure. We also performed a review of the scientific literature of the endovascular treatment of stenosis and occlusions of large venous vessels. Results: The endovascular procedure has shown an excellent result of recanalization of a collapsed and acute occluded venous stent. PTA is always recommended as the first line of endovascular treatment of venous steno-occlusions. As far as we know, there are no studies with large case series describing the results analyzed in our clinical case. Conclusions: Our experience suggests promising results of the use of the stent Covera Plus. However, it is essential to carry out safety and efficacy studies of the treatment on large series and in the long term.