Role of Ultra High Pressure Balloon Angioplasty in the Management of Central Venous Stenosis or Occlusion in Hemodialysis Patients

Eid, Ahmed Walid Abdel Wahab; Helmy, Amr Hamdy; Osman, Osman Abouelcibaa; Abdel Gany, Mostafa Mohamed

doi:10.21608/mjmr.2025.403793.2028

Role of Ultra High Pressure Balloon Angioplasty in the Management of Central Venous Stenosis or Occlusion in Hemodialysis Patients

Articles in Press

Document Type : Original Article

Authors

¹ Vascular surgery department, Minia University Hospital

² Vascular Surgery Department, Minia Faculty of Medicine, Minia University Hospitals

³ Vascular surgery Unit, general surgery department, faculty of medicine, Minia university. Minia , Egypt

10.21608/mjmr.2025.403793.2028

Abstract

Background: Venous hypertention is a significant complication of hemodialysis vascular access that leads to morbidity, salvage procedures, and potentially new access placement. Objective: To determine the role of ultra-high (UHP) pressure balloon angioplasty in the management of central venous stenosis or occlusion in chronic hemodialysis patients. Patients and Methods: A prospective study of 20 end stage renal disease patients with venous hypertension due to central veins stenosis or occlusion referred to the vascular surgery unit at Minia University hospital between June 2023 to May 2024 was conducted. Pre-operative clinical and radiological (duplex and venography) assessment of venous system were performed. Intervention included ultra- high / high pressure balloon (MUSTANG ™) angioplasty or stent insertion (VENOUS WALLSTENT™). Results: Our study showed a high success rate with ultra-high pressure balloon angioplasty, achieving 80% patency at 1 week, 93.8% at 1 month, 93.3% at 3 months, and 92.9% at 6 months. These results reflect excellent short- and mid-term outcomes, even in a challenging cohort with central venous stenosis and occlusion. Notably, no life-threatening complications such as pericardial tamponade or procedure-related mortality were reported. This supports the safety profile of UHP balloon angioplasty when performed with appropriate technique and imaging guidance. Conclusions: The use of UHP balloon angioplasty is a safe and highly effective modality for the salvage and maintenance of arteriovenous access in patients with end-stage renal disease suffering from central venous stenosis or occlusion and associated venous hypertension.

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