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Case Reports
. 2025 May;26(3):1041-1045.
doi: 10.1177/11297298241250372. Epub 2024 May 6.

Cavoatrial junction stenting in vascular hemodialysis catheter malfunction

Federico Francisco Pennetta  1 , Massimiliano Millarelli  2 , Francesco De Santis  2 , Alessandra Bandiera  3 , Matteo Tozzi  3 , Roberto Chiappa  2
Affiliations
Case Reports

Cavoatrial junction stenting in vascular hemodialysis catheter malfunction

Federico Francisco Pennetta et al. J Vasc Access. 2025 May.

Abstract

In patients undergoing hemodialytic treatment via intravascular catheters, stenosis or occlusion of central veins is common. Despite an extensive characterization of Superior Vena Cava Syndrome (SVCS) no data is available about CavoAtrial Junction (CAJ) stenosis. We report the case of two patients with a story of multiple catheter failures due to thrombosis or infection. Computed tomography (CT) showed radiological signs of CAJ stenosis confirmed at the following venography. In absence of other feasible options to place a vascular access, the two underwent stenting with Gore Viabahn VBX balloon expandable endoprosthesis (W.L. Gore & Associates, Flagstaff, AZ, USA) of the CAJ stenosis. Completion venography showed complete resolution of the stenosis in both patients. No complications occurred during the procedures. At a mean follow-up of 878 ± 559 days no signs of in-stent restenosis or recoil were found. The present cases emphasize the feasibility and safety of CAJ stenting, underlining the importance of preserving CAJ and upper veins patency in hemodialysis access.

Keywords: Hemodialysis; large upper vein stenosis; stenting; superior vena cava syndrome; vascular access.

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Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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