Stent use for hemodialysis access: What a general nephrologist needs to know.

ABSTRACT

Recurrent stenosis due to neo-intimal hyperplasia leads to loss of patency in an established hemodialysis access. The current treatment strategy to maintain patency involves percutaneous transluminal angioplasty with or without stent placement. There are several key points that an interventionalist needs to weigh before deciding to place a stent. These include appropriateness of stent placement, the long term consequences, the type of stent to be deployed, the size of stent and finally the impact on cannulation during dialysis. A general nephrologist needs to be aware of the various benefits and pitfalls of stent placement. The current review provides basic information that will educate the dialysis provider about stents and its use in treating dysfunctional hemodialysis access using commonly encountered clinical scenarios.