Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Effectiveness of sharp recanalization of superior vena cava-right atrium junction occlusion
Xiao-Wen Wu, Xu-Ya Zhao, Xing Li, Jun-Xiang Li, Zong-Yang Liu, Zhi Huang, Ling Zhang, Chong-Yang Sima, Yu Huang, Lei Chen, Shi Zhou
Xiao-Wen Wu, Xu-Ya Zhao, Jun-Xiang Li, Yu Huang, Lei Chen, Department of Interventional Radiology, Guizhou Cancer Hospital, Guiyang 550000, Guizhou Province, China
Xing Li, Zhi Huang, Shi Zhou, Department of Interventional Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
Zong-Yang Liu, Department of Nephrology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
Ling Zhang, Department of Nursing, Guizhou Cancer Hospital, Guiyang 550000, Guizhou Province, China
Chong-Yang Sima, Department of Nephrology, Guizhou Cancer Hospital, Guiyang 550000, Guizhou Province, China
Author contributions: Wu XW, Zhao XY and Zhou S made substantial contributions to conception and design, acquisition, analysis and interpretation of data and drafting the article or revising it critically for important intellectual content; Li X, Li JX, Liu ZY, Huang Z, Zhang L, Sima CY, Huang Y and Chen L made substantial contributions to acquisition and interpretation of data and revising it critically for important intellectual content; All authors gave final approval of the version to be submitted.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Guizhou Cancer Hospital (approval No. FZ 2019-09-219).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Shi Zhou, BSc, Doctor, Department of Interventional Radiology, The Affiliated Hospital of Guizhou Medical University, No. 1 Beijing Road, Yunyan District, Guiyang 550000, Guizhou Province, China.
82574263@qq.com
Received: December 9, 2020
Peer-review started: December 9, 2020
First decision: February 12, 2021
Revised: March 17, 2021
Accepted: March 29, 2021
Article in press: March 29, 2021
Published online: June 6, 2021
Processing time: 155 Days and 22.4 Hours
ARTICLE HIGHLIGHTS
Research background
Conventional recanalization techniques may fail in patients with completely occluded superior vena cava (SVC).
Research motivation
Although most central vein stenosis can be treated with a relatively good effect using conventional intravascular blunt recanalization using guidewires and catheters, the remaining options are limited in cases of failure of traditional recanalization.
Research objectives
This study aimed to analyze the effectiveness and complications of sharp recanalization for completely occluded SVC.
Research methods
This was a retrospective study of patients that underwent puncture and recanalization of the SVC between January 2016 and December 2017 at our hospital. Sharp recanalization was performed using the RUPS-100 system. The patients were followed for 12 mo. The main outcomes were the patency rate of SVC and AVF flow during dialysis.
Research results
The procedure was successful in all 14 patients (100%). Blood pressure in the distal SVC decreased in all 14 cases (100%) from 26.4 ± 2.7 cmH2O to 14.7 ± 1.3 cmH2O (P < 0.05). The first patency rates of the SVC at 24 h and at 3, 6, 9 and 12 mo after sharp recanalization were 100%, 92.9%, 85.7%, 78.6% and 71.4%, respectively. There were two (14.3%) severe, one (7.1%) moderate and one (7.1%) minor complication. The severe complications included one case of pericardial tamponade and one case of hemothorax.
Research conclusions
The results suggest that sharp recanalization can be an additional tool to extend or renew the use of an occluded upper extremity access for hemodialysis. This could be of use in patients with long-term maintenance hemodialysis in whom the maintenance of central venous access is often a challenge.
Research perspectives
The clinical and therapeutic results of benign SVC syndrome after stenting were not significantly different between patients with and without postoperative anticoagulation. This point still needs further research for confirmation.
