الفهرس 
Development of The Venous System Of Upper LimbOnly 14 pages are availabe for public view
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Abstract
Placement of central venous catheters or venous interventions is the most important risk factors for COVD.
PTA with possible stent implantation is the method of first choice in the treatment of central vein stenoses or oc-clusions. PTA is a safe and efficient method with a high rate of success, almost 100 %, for stenoses,
Stent implantation must be seriously considered, because the results show that at 12 months the primary patency is well comparable with simple angioplasty. Both in PTA and stent implantation it is necessary to expect the occurrence of restenoses, which can be treated by means of balloon angioplasty Despite the high rates of primary success obtained treating stenoses, the current options for treatment of this disease will, sooner or later, lead to restenosis or occlusion, requiring multiple interventions to maintain patency. This being the case, further controlled and randomized studies into the available treatment options are needed to develop adequate treatment algorithms. Further advances in techniques and new technologies and materials for treatment are also needed in order to achieve better results, including in venous occlusion cases, which are the greatest challenge to treat.
It is concluded that, in view of the great difficulty in achieving satisfactory results, prevention is paramount, including rational use of central venous access and appropriate planning of creation of arteriovenous fistulas in predialytic patients. As is the case with renal dysfunction, placement of central venous catheters should be avoided when possible and particularly so in the subclavian vein. Furthermore, use of other peripheral venous access routes should be minimized to preserve future venous access
In spite of the relatively frequent reinterventions, the percutaneous method of treatment is efficient and capable to preserve the function of the dialysis shunt in the long-term. Prior to shunt placement, possible affection of the central veins must be ruled out.