The establishment and maintenance of adequate vascular access in chronic kidney disease patients for haemodialysis is vital to their survival and quality of life. Arteriovenous fistulas (AVF) are widely accepted as the first-line method of access worldwide due to its longevity and lower morbidity and mortality rates, as compared to central venous catheter access and arteriovenous grafts [1]. Cephalic arch stenosis (CAS) is known to cause dysfunction in brachiocephalic AVF’s [2-4]. Percutaneous transluminal angioplasty (PTA) and bare metal stents (BMS) have previously been used for...

A retrospective analysis of patients that had undergone isolated cephalic arch stent graft placement in our institution between 2009 and 2018. PACS Sectra (Sectra®, AB Sweden) was used to establish the data collection for review. Both de novo and recurrent stenosis patients with only single stent graft placement at the cephalic arch were included. To determine further interventions, the electronic patient records and RenalWare (RenalWare® Nephrology database, Airslie Ltd) was accessed to review all subsequent dialysis sessions, further endovascular and surgical interventions, loss of fistula...

43 patients - 13 with thrombosed fistulas and 30 non-thrombosed fistulas 22 men & 21 women Mean age 65 (range 28 - 88) Most common indications for initial referral were high venous pressure on dialysis and prolonged bleeding time post-dialysis (Figure 1). 19 patients had no previous intervention and 24 patients had undergone previous intervention at the cephalic arch. Technical and clinical success was achieved by standard definitions (SIR guidelines [5]) in all cases.

Stent grafts are a safe and effective treatment modality for dysfunctional arteriovenous fistula secondary to CAS, and compares favourably to PTA and BMS in durability [4]. The results of this retrospective study demonstrate comparable effectiveness and durability at our institution when compared to other studies, both nationally [6] and internationally [4,7].

S. Lam; London/UK - nothing to disclose F. Arfeen; London, LONDON/UK - nothing to disclose A. Hussain; London/UK - nothing to disclose J. Kyaw Tun; London/UK - nothing to disclose O. Jaffer; London/UK - nothing to disclose

Quarello F, Forneris G, Borca M, Pozzato M. Do central venous catheters have advantages over arteriovenous fistulas or grafts? J Nephrol. 2006;19:265–279. Kian K, Asif A. Cephalic Arch Stenosis. Seminars in Dialysis. 2007;21(1):78-82. Rajan D, Clark T, Patel N, Stavropoulos S, Simons M. Prevalence and Treatment of Cephalic Arch Stenosis in Dysfunctional Autogenous Hemodialysis Fistulas. Journal of Vascular and Interventional Radiology. 2003;14(5):567-573. D’cruz R, Leong S, Syn N, Tiwari A, Sannasi V, Singh Sidhu H et al. Endovascular treatment of cephalic arch stenosis in brachiocephalic...