1Sara Mokhtari, 1Imad Eddine El Qsimi, 1Oussama Anane, 1Taha Abualtayef, 1Adnane Benzirar, 1Omar El Mahi

1Vascular Surgery Department. Mohammed Vi University Hospital, Oujda, Morocco

 

Case Report:

It is about a descriptive and retrospective study concerning 8 cases of HP with CVO. The patients were hospitalized in Vascular Surgery Department of Mohammed VI University Hospital between December 2019 and November 2020. Clinical, paraclinical and epidemiological profiles of each case were noted and analyzed as well as the treatment modalities and follow-up.                                                                                                                                                                                                                                                                                                                                                                                                                                                 

Material(s) and Method(s):

It is about a descriptive and retrospective study concerning 8 cases of HP with CVO. The patients were hospitalized in Vascular Surgery Department of Mohammed VI University Hospital between December 2019 and November 2020. Clinical, paraclinical and epidemiological profiles of each case were noted and analyzed as well as the treatment modalities and follow-up.

Results:

8 chronic hemodialysis patients with CVO disease were treated with EV treatment. They ranged in age from 48 to 85 years (mean age: 64,5 years old). The sex ratio was 5F/3M. An antecedent of inserted CVC was common in all patients. The treated lesion was ipsilateral to CVC in 73%. Lack of thrill perception (100%), cutaneous symptoms (75%), isolated edema of the upper limb (62,5%) and superior vena cava syndrome  (37,5%) were the principal clinical presentations of CVO. All patients benefited from phlebography or fistulography. The latter confirmed the diagnosis and visualized a single stenosis in 5 patients while 3 patients presented 2 different sites of stenosis. Innominate trunk (IT) was the leading stenosis localization (70%) followed by subclavian vein (20%), IT-subclavian vein junction (5%) and SVC (5%). A primary stenting was required in 50% of cases. No complications were detected. The primary patency for transluminal angioplasty (TLA) and stenting (S) groups are respectively at 100% at 1st month, 75% at 3rd month and 0% vs 50% at 6th month while the secondary patency for TLA group was 75% vs 100% for S group.                                                                                                                                      

Conclusion(s):

EV treatment of CVOHP represents a paradigm shift in the management of this venous pathology as it provides the extension of AV fistulas median duration to maintain access patency for dialysis, and so the patient’s life expectancy.