Chinese Journal of Blood Purification ›› 2013, Vol. 12 ›› Issue (11): 598-601.doi: 10.3969/j.issn.1671-4091.2013.11.00

Previous Articles     Next Articles

Endovascular therapy to the upper extremity edema syndrome and analyzing to recurrence.

  

  • Received:2013-06-04 Revised:2013-07-11 Online:2013-11-12 Published:2013-11-12

Abstract: Objective To analyze the clinical characters of upper extremity edema syndrome in hemodialysis patients, explore the endovascular therapy way to this syndrome and investigate the recur causes . Methods Eighty eight upper extremity edema syndrome patients were recruited. And 116 percutaneous transluminal angioplasty therapies were carried out. The subjects were classified into two groups according to whether the edema symptoms were emerged once more. If central vein stenosis or obstruction were diagnosed with X ray, endovascular therapies including angioplasty or stent placement. Evaluate the relation between the central vein stenosis and the history of central venous catheter inserted and investigate the influencing factors to recurrence. Results All patients received endovascular therapy were recovered unless fifteen patients received other therapies and central vein stenosis were not found in three patients. Fifty patients had the history of ipsilateral central vein catheter inserted. From the fistulation to the symptom of upper extremity edema appeared , 26.4±32.5 months had been passed. Central vein stenosis or obstruction in subclavian vein and brachiocephalic vein were mostly been seen among all causes. In the investigating duration, 23 patients had to face the recurrence of the edema and total recur were 35 times within 7 months after endovascular therapy. And statistical difference were not found between two groups (P>0.05). But the ratio of stent placement in recurrence group was higher though statistical difference wasn’t existed (P>0.05). Conclusion The upper extremity edema syndrome in hemodialysis patients was caused by the insertion of the central vein catheter and the change of hemodynamics in the central vein after fistula. Recurrence often be seen in these patients even if they had been received endovascular therapy, especially in the patients who received stent placement.

Key words: Hemodialysis, Upper extremity edema syndrome, Central vein stenosis, Endovascular therapy.