Lesion Type Analysis of Hemodialysis Patients Who Underwent Endovascular Management for Symptomatic Central Venous Disease

Figures & data

Table 1 Characteristics and Clinical Presentations of Hemodialysis Patients with Central Vein Disease

Associated Variables	Number	Percent (%)
	Mean ± SD
Sex
Male	37	56.1
Female	29	43.9
Age (y)	51.9 ± 14.9
Age category
Young adults (21–40 y)	15	22.7
Old adults (41–60 y)	31	47.0
Seniors (61–80 y)	20	30.3
Comorbidities
Diabetes mellitus	31	47.0^a↑↑
Hypertension	52	78.8^a↑↑↑
Dyslipidemia	15	22.7
Stroke	4	6.1
Myocardial infarction	13	19.7
Peripheral vascular disease	6	9.1
Duration of hemodialysis (y)	6.8 ± 4.1
Type of central vein lesion
Stenosis	39	59.1
Occlusion	27	40.9
Number of lesions/patient
1	42	63.6
2	20	30.3
3	4	6.1
Side of the lesion
Right	29	43.9
Left	35	53.0
Both	2	3.0
Affected vein
Subclavian	10	15.2
Internal jugular	1	1.5
Brachiocephalic	29	43.9^b↑↑↑
Superior vena cava	2	3.0
Combined (more than one vein)	24	36.4
Patients with previous central line catheterization	41	62.1
Number of central line catheters per patient
0	25	37.9
1	30	45.4
2	10	15.2
More than 2	1	1.5
Side of central line catheterization
Right	19	46.3
Left	14	34.2
Both	8	19.5
Presence of AVF	60	90.9
Side of the AVF
Right	20	33.3
Left	31	51.7
Both	9	15.0
Presence of AVG	6	9.1

Notes: ^a↑↑Significantly higher than expected frequency of comorbidity (P<0.01, χ²; AR= 3.2). ^a↑↑↑Significantly higher than expected frequency of comorbidity (P<0.001, χ²; AR= 9.3). ^b↑↑↑Significantly higher than expected frequency for this vein (P<0.001, χ²; AR= 5.4).

Abbreviations: AVF, arteriovenous fistula; AVG, arteriovenous graft; SD, standard deviation; y, years.

Figure 1 The anatomical distribution of solitary central vein lesions in hemodialysis patients. Combined lesions (not illustrated) contributed to 24 (36.4%) of the patients as follow: 9 (13.6%) cases involved SCV + BCV, 9 (13.6%) cases BCV + SVC, 2 (3.0%) cases SCV+BCV+SVC, 1 (1.5%) case IJV + SVC, 1 (1.5%) case IJV + BCV, 1 (1.5%) case IJV + BCV + SVC, and 1 (1.5%) case SCV + IJV + BCV.

Abbreviations: IJV, internal jugular vein; SCV, subclavian vein; BCV, brachiocephalic vein; SVC, superior vena cava.

Table 2 Factors Associated with the Type of Central Vein Lesion (Stenosis Vs Occlusion) in Hemodialysis Patients

Lesion Type	Stenosis N (% from Stenosis)	Occlusion N (% from Occlusion)	P-value
Sex
Male	21 (53.8)	16 (59.3)	NS
Female	18 (46.2)	11 (40.7)
Age (y), mean ± SD	52.0 ± 14.8	51.7 ± 15.4	NS
Age category
Young adults (21–40 y)	9 (23.1)	6 (22.2)	NS
Old adults (41–60 y)	19 (48.7)	12 (44.4)
Seniors (61–80 y)	11 (28.2)	9 (33.3)
Comorbidities
Diabetes mellitus	18 (46.2)	13 (48.1)	NS
Hypertension	29 (74.4)	23 (85.2)	NS
Dyslipidemia	9 (23.1)	6 (22.2)	NS
Stroke	3 (7.7)	1 (3.7)	NS
Myocardial infarction	7 (17.9)	6 (22.2)	NS
Peripheral vascular disease	4 (10.3)	2 (7.4)	NS
Number of lesions per patient
1	26 (66.7)	16 (59.3)	NS
2	10 (25.6)	10 (37.0)
3	3 (7.7)	1 (3.7)
Affected vein
Subclavian	8 (20.5)	2 (7.4)	NS
Internal jugular	0 (0.0)	1 (3.7)
Brachiocephalic	16 (41.0)	13 (48.1)
Superior vena cava	2 (5.1)	0 (0.0)
Combined (more than one vein)	13 (33.3)	11 (40.7)
Previous central line catheterization	24 (61.5)	17 (63.0)	NS
Number of central line catheters per patient
0	15 (38.5)	10 (37.0)	NS
1	20 (51.3)	10 (37.0)	NS
2	3 (7.7)	7 (25.9)^↑	0.04
More than 2	1 (2.6)	0 (0.0)	NS
Presence of AVF	35 (89.7)	25 (92.6)	NS
Technical outcome (recanalization)
Success	31 (91.2)^↑↑	12 (54.5)	< 0.01
Fail	3 (8.8)	10 (45.5)^↑↑

Notes: ^↑(P<0.05), ^↑↑(P<0.01): significantly higher than expected frequency, χ².

Abbreviations: AVF, arteriovenous fistula; N, number; NS, not significant; P, probability; SD, standard deviation; y, years.

Table 3 Factors Associated with the Side of the Central Vein Lesion in Hemodialysis Patients

Lesion Side	Right N (%)	Left N (%)	Both N (%)	P-value
Sex
Male	18 (62.1)	19 (54.3)	0 (0.0)	NS
Female	11 (37.9)	16 (45.7)	2 (100.0)
Age (y)
Mean ± SD	48.6 ± 13.8	54.6 ± 15.8	50.5 ± 12.0	NS
Age category
Young adults (21–40 y)	8 (27.6)	7 (20.0)	0 (0.0)	NS
Old adults (41–60 y)	16 (55.2)	13 (37.1)	2 (100.0)
Seniors (61–80 y)	5 (17.2)	15 (42.9)	0 (0.0)
Number of lesions per patient
1	17 (58.6)	25 (71.4)	0 (0.0)	0.043
2	11 (37.9)	8 (22.9)	1 (50.0)
3	1 (3.4)	2 (5.7)	1 (50.0)^↑
Affected vein
Subclavian	3 (10.3)	7 (20.0)	0 (0.0)	NS
Internal jugular	1 (3.4)	0 (0.0)	0 (0.0)
Brachiocephalic	11 (37.9)	18 (51.4)	0 (0.0)
Superior vena cava	2 (6.9)	0 (0.0)	0 (0.0)
Combined (more than one vein)	12 (41.4)	10 (28.6)	2 (100.0)
Catheterization side
Right	14 (73.7)^↑↑	5 (23.8)	0 (0.0)	0.003
Left	2 (10.5)	12 (57.1)^↑↑	0 (0.0)
Both	3 (15.8)	4 (19.0)	1 (100.0)^↑
Side of AVF
Right	17 (63.0)^↑↑	3 (9.7)	0 (0.0)	<0.001
Left	6 (22.2)	24 (77.4)^↑↑	1 (50.0)
Both	4 (14.8)	4 (12.9)	1 (50.0)

Notes: ^↑(P<0.05), ^↑↑(P<0.01): significantly higher than expected frequency, χ².

Abbreviations: AVF, arteriovenous fistula; N, number; NS, not significant; P, probability; SD, standard deviation; y, years.

Table 4 Factors Associated with Installation of a Central Venous Catheter in Hemodialysis Patients with Central Vein Disease

Central Venous Catheter	Yes N (%)	No N (%)	P-value
Sex
Male	23 (56.1)	14 (56.0)	NS
Female	18 (43.9)	11 (44.0)
Age (y)
Mean ± SD	52.3 ± 13.4	51.2 ± 17.5	NS
Age category
Young adults (21–40 y)	6 (14.6)^↓	9 (36.0)	0.04
Old adults (41–60 y)	22 (53.7)	9 (36.0)	NS
Seniors (61–80 y)	13 (31.7)	7 (28.0)	NS
Comorbidities
Diabetes mellitus	21 (51.2)	10 (40.0)	NS
Hypertension	33 (80.5)	19 (76.0)	NS
Dyslipidemia	13 (31.7)^↑	2 (8.0)	0.03
Stroke	3 (7.3)	1 (4.0)	NS
Myocardial infarction	9 (22.0)	4 (16.0)	NS
Peripheral vascular disease	3 (7.3)	3 (12.0)	NS
Affected vein
Subclavian	5 (12.2)	5 (20.0)	NS
Internal jugular	1 (2.4)	0 (0.0)
Brachiocephalic	19 (46.3)	10 (40.0)
Superior vena cava	1 (2.4)	1 (4.0)
Combined (more than one vein)	15 (36.6)	9 (36.0)
Presence of AVF
Yes	41 (100.0)^↑↑	19 (76.0)	< 0.001
No	0 (0.0)	6 (24.0)
Technical outcome
Success	26 (74.3)	17 (81.0)	NS
Fail	9 (25.7)	4 (19.0)

Notes: ^↑(P<0.05), ^↑↑(P<0.01): significantly higher than expected frequency, χ^{2. ↓}(P<0.05): significantly less than expected frequency, χ².

Abbreviations: AVF, arteriovenous fistula; N, number; NS, not significant; P, probability; SD, standard deviation; y, years.