Central Venous Stenosis and Occlusion in Dialysis Patients: A Technical and Outcome-Based Analysis of Endovascular Intervention

Endovascular revascularization of CVS/CVO in hemodialysis patients is safe and offers high technical success. While primary patency declines over time, cumulative patency remains favorable, underscoring the role of timely reinterventions and structured surveillance in prolonging access life.Clinical ImpactThis study reinforces endovascular revascularization as a safe and effective first-line strategy for managing central venous stenosis and occlusion in hemodialysis patients, allowing immediate reuse of the vascular access and avoiding dialysis interruption. The data highlight that long-term success depends less on a single "perfect" procedure and more on structured surveillance and timely reintervention. Prior ipsilateral central venous catheter placement emerges as a key predictor of failure, underscoring the need to minimize catheter use and promote early AVF creation. From a practical standpoint, selective primary stenting in long or recoil-prone lesions and careful attention to stent durability can meaningfully prolong access lifespan in this fragile population.