EP14: Upper Limb Edema - A Single Centre Experience

Upper limb edema in hemodialysis patients Upper limb edema in hemodialysis patients A single centre experience A single centre experience Venkatesh Rajkumar Apollo speciality hospitals, Chennai •Upper limb edema is a common problem in long term hemodialysis patients •The most common etiology is venous hypertension •The site of venous obstruction varies from venous outflow tract to central veins •To evaluate the etiology of upper limb edema •To assess the effectiveness of endovascular interventions in venous edema • Prospective analysis (Jan 2015- Jun 2016) • All patients presenting to our dialysis unit with isolated upper extremity swelling were included • A fistulogram was performed Total number of patients included n=10 ETIOLOGY OF EDEMA: •Central venous stenosis(CVS) : 7 ( all left brachiocephalic) •Venous outflow tract obstruction :2 ( both were at graft vein anastomosis) •Other causes :1 ( Venous HT due to side to side Brachio basilic fistula) PROCEDURES DONE: • Central vein stenosis is the commonest cause of venous edema (70%) followed by venous outflow obstruction (20%). • All the patients with central stenosis had previous history of temporary jugular catheter insertions. • Both the cases of graft vein anastamotic stenosis responded completely to PTA and are still on follow up. • Four out of six cases of central stenosis responded completely. Two had a partial recanalization with partial resolution of edema. • AV fistula could be used successfully in all of the patients post angioplasty. • Complications were mainly in the form of small hematomas (grade 1) in two patients Aim Introduction METHODS RESULTS Patients presenting with edema (N =16) AV Graft : 2 Brachio Axillary AV fistula : 8 Left Radio cephalic: 6 Left Ulnar basilic: 1 Left Brachio Basilic: 1 DISCUSSION CONCLUSION Venous stenosis presenting as upper limb edema could be effectively managed by percutaneous angioplasties on them with a very high technical and clinical success rate and with an acceptable rate of complications ACKNOWLEDGEMENT: I hereby thank the Indian society of Nephrology and the International society of Nephrology for having helped me enter the field of Interventional Nephrology Not willing for the procedur e: 6 Patients who underwent fistulogra m:10

Upload
akshay-kapoor
Category

Education
view
12
download
0

Embed Size (px):

Transcript of EP14: Upper Limb Edema - A Single Centre Experience

Page 1: EP14: Upper Limb Edema - A Single Centre Experience

Upper limb edema in hemodialysis patients Upper limb edema in hemodialysis patients A single centre experienceA single centre experience

Venkatesh RajkumarApollo speciality hospitals, Chennai

•Upper limb edema is a common problem in long term hemodialysis patients•The most common etiology is venous hypertension•The site of venous obstruction varies from venous outflow tract to central veins

•To evaluate the etiology of upper limb edema•To assess the effectiveness of endovascular interventions in venous edema

• Prospective analysis (Jan 2015- Jun 2016)• All patients presenting to our dialysis unit with

isolated upper extremity swelling were included • A fistulogram was performed

Total number of patients included n=10

ETIOLOGY OF EDEMA:•Central venous stenosis(CVS) : 7 ( all left brachiocephalic)•Venous outflow tract obstruction :2 ( both were at graft vein anastomosis)•Other causes :1 ( Venous HT due to side to side Brachio basilic fistula)

PROCEDURES DONE:

• Central vein stenosis is the commonest cause of venous edema (70%) followed by venous outflow obstruction (20%).

• All the patients with central stenosis had previous history of temporary jugular catheter insertions.

• Both the cases of graft vein anastamotic stenosis responded completely to PTA and are still on follow up.

• Four out of six cases of central stenosis responded completely. Two had a partial recanalization with partial resolution of edema.

• AV fistula could be used successfully in all of the patients post angioplasty.

• Complications were mainly in the form of small hematomas (grade 1) in two patients

Aim

Introduction

METHODS

RESULTS

Patients presenting with edema (N =16)

AV Graft : 2Brachio Axillary

AV fistula : 8 Left Radio cephalic: 6 Left Ulnar basilic: 1 Left Brachio Basilic: 1

DISCUSSION

CONCLUSIONVenous stenosis presenting as upper limb edema could be effectively managed by percutaneous angioplasties on them with a very high technical and clinical success rate and with an acceptable rate of complications

ACKNOWLEDGEMENT:I hereby thank the Indian society of Nephrology and the International society of Nephrology for having helped me enter the field of Interventional Nephrology

Not willing for the procedure: 6

Patients who underwent fistulogram:10