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논문분류	춘계학술대회 초록집
제목	Stent-Graft Use as an Endovascular Revision
저자	Jeeyoung Yoon
출판정보	2025; 2025(1):
키워드	stent graft, endovascular revision
초록	Introduction Hemodialysis (HD) requires reliable vascular access, but artificial exposure of veins to arterial pressure often leads to neointimal hyperplasia (NIH) or venous stenosis. Due to the limitations of Percutaneous transluminal angioplasty (PTA) as an endovascular therapy for dysfunctional arteriovenous fistulas. Stent grafts (SGs) or covered stent, have been introduced to prevent in-stent restenosis (ISR) and effective rescue therapy for recurrent venous anastomotic stenosis in arteriovenous grafts (AVGs), cephalic arch stenosis in AVFs, and central vein stenosis requiring frequent interventions. Case A 50-year-old female patient with systemic lupus erythematosus (SLE)-associated end-stage renal disease (ESRD). Brachio-axillary AVG, Lt. was created and started to be used 40 days after the creation. But the recurrent AVG thrombosis occurred due to venous anastomotic stenosis. Due to the AVG thrombosis, mechanical thrombolysis was performed six days after the first puncture and PTA was performed three weeks after the first puncture. However, AVG thrombosis recurred repeatedly despite these interventions. To restore patency, SG insertion was performed, and at seven months of follow-up, the AVG remained functional with stable access. Conclusion In this case, venous anastomotic stenosis leading to frequent, very early AVG thrombosis was successfully salvaged with stent graft insertion as an endovascular revision. The use of SG as an endovascular revision can be superior to surgical revision, because it eliminates the risk of vein lengthening that may occur during surgical revision.
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