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The feasibility and safety of a through-and-through wire technique for central venous occlusion in dialysis patients

BACKGROUND: To retrospectively compare the operation time, success rate and efficacy between unidirectional and bidirectional procedures in the treatment of central venous occlusion diseases (CVOD), assess the advantages of the bidirectional approach, and determine the characteristics of CVOD approp...

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Autores principales: Huang, Yonghui, Chen, Bing, Tan, Guosheng, Cheng, Gang, Zhang, Yi, Li, Jiaping, Yang, Jianyong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5142130/
https://www.ncbi.nlm.nih.gov/pubmed/27923353
http://dx.doi.org/10.1186/s12872-016-0411-3
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author Huang, Yonghui
Chen, Bing
Tan, Guosheng
Cheng, Gang
Zhang, Yi
Li, Jiaping
Yang, Jianyong
author_facet Huang, Yonghui
Chen, Bing
Tan, Guosheng
Cheng, Gang
Zhang, Yi
Li, Jiaping
Yang, Jianyong
author_sort Huang, Yonghui
collection PubMed
description BACKGROUND: To retrospectively compare the operation time, success rate and efficacy between unidirectional and bidirectional procedures in the treatment of central venous occlusion diseases (CVOD), assess the advantages of the bidirectional approach, and determine the characteristics of CVOD appropriate for the bidirectional approach treatment. METHODS: A total of 49 patients who underwent endovascular interventions with all relevant data between January 2011 and December 2015 at the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China, were included in this retrospective study, and were categorized into two groups: the 19 patients in group 1 had undergone percutaneous transluminal venoplasty (PTV) via a conventional technique (unidirectional procedure from the vein distal or proximal to the obstructive lesion), and the 30 in group 2 had undergone flossing wire technique (bidirectional procedure from femoral vein and the vein distal to obstructive lesion and using a flossing wire technique). The technical success rate, the fluoroscopy time in the procedure, perioperative complications, and patency were evaluated retrospectively. RESULTS: Compared with group 1, group 2 had a higher initial technical success rate (83.33% vs. 47.36%, p = 0.012) but a shorter fluoroscopy time (82.6 ± 26.1 vs. 116.1 ± 42.1, p = 0.048). Receiver operating characteristic (ROC) analysis indicated that a lesion with a length of 6.5 cm was the best predictor of technique success (p = 0.02) in group 1, but no cut-off value was identified for group 2. There were no significant differences in perioperative complications between these two groups. The complication rates were 31.58% (6/19) in group 1 and 6.67% (2/30) in group 2, (p = 0.043), respectively. No significant difference was observed between these two groups with respect to the stent patency rate. CONCLUSION: Compared with the conventional technique, the flossing wire technique has a higher success rate, shorter fluoroscopy time, fewer complications and similar patency rate. It is a feasible treatment for CVOD, especially for long obstructive lesions.
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spelling pubmed-51421302016-12-15 The feasibility and safety of a through-and-through wire technique for central venous occlusion in dialysis patients Huang, Yonghui Chen, Bing Tan, Guosheng Cheng, Gang Zhang, Yi Li, Jiaping Yang, Jianyong BMC Cardiovasc Disord Research Article BACKGROUND: To retrospectively compare the operation time, success rate and efficacy between unidirectional and bidirectional procedures in the treatment of central venous occlusion diseases (CVOD), assess the advantages of the bidirectional approach, and determine the characteristics of CVOD appropriate for the bidirectional approach treatment. METHODS: A total of 49 patients who underwent endovascular interventions with all relevant data between January 2011 and December 2015 at the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China, were included in this retrospective study, and were categorized into two groups: the 19 patients in group 1 had undergone percutaneous transluminal venoplasty (PTV) via a conventional technique (unidirectional procedure from the vein distal or proximal to the obstructive lesion), and the 30 in group 2 had undergone flossing wire technique (bidirectional procedure from femoral vein and the vein distal to obstructive lesion and using a flossing wire technique). The technical success rate, the fluoroscopy time in the procedure, perioperative complications, and patency were evaluated retrospectively. RESULTS: Compared with group 1, group 2 had a higher initial technical success rate (83.33% vs. 47.36%, p = 0.012) but a shorter fluoroscopy time (82.6 ± 26.1 vs. 116.1 ± 42.1, p = 0.048). Receiver operating characteristic (ROC) analysis indicated that a lesion with a length of 6.5 cm was the best predictor of technique success (p = 0.02) in group 1, but no cut-off value was identified for group 2. There were no significant differences in perioperative complications between these two groups. The complication rates were 31.58% (6/19) in group 1 and 6.67% (2/30) in group 2, (p = 0.043), respectively. No significant difference was observed between these two groups with respect to the stent patency rate. CONCLUSION: Compared with the conventional technique, the flossing wire technique has a higher success rate, shorter fluoroscopy time, fewer complications and similar patency rate. It is a feasible treatment for CVOD, especially for long obstructive lesions. BioMed Central 2016-12-07 /pmc/articles/PMC5142130/ /pubmed/27923353 http://dx.doi.org/10.1186/s12872-016-0411-3 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Huang, Yonghui
Chen, Bing
Tan, Guosheng
Cheng, Gang
Zhang, Yi
Li, Jiaping
Yang, Jianyong
The feasibility and safety of a through-and-through wire technique for central venous occlusion in dialysis patients
title The feasibility and safety of a through-and-through wire technique for central venous occlusion in dialysis patients
title_full The feasibility and safety of a through-and-through wire technique for central venous occlusion in dialysis patients
title_fullStr The feasibility and safety of a through-and-through wire technique for central venous occlusion in dialysis patients
title_full_unstemmed The feasibility and safety of a through-and-through wire technique for central venous occlusion in dialysis patients
title_short The feasibility and safety of a through-and-through wire technique for central venous occlusion in dialysis patients
title_sort feasibility and safety of a through-and-through wire technique for central venous occlusion in dialysis patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5142130/
https://www.ncbi.nlm.nih.gov/pubmed/27923353
http://dx.doi.org/10.1186/s12872-016-0411-3
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