الفهرس 
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Abstract
The aim of the study is to evaluate the patency of the endovascular management for the venous hypertension in haemodialysis access patient having upper limb AVF.
This study was carried out on 50 patients presented with venous hypertension in upper limb AVF. 60% of the patients were females while 40% of patients were males where the mean age of the studied patients was 47.77 ± 10.49 (22.0 – 72.0).
Fourty one of patients had previously underwent ipsilateral central venous cathertrization. The remaining nine lesions were not associated with central venous cathertrization , which reflect importance of CVC insertion as primary risk factor for developing central venous system occlusions.
The lesions were most commonly located in the innominate vein . It was involved in 32 (64%) of lesions followed by the axillary vein in 11 (22%) of lesions , the subclevian vein in 10 (20%), and superior vena cava in 4 cases. The degree of stenosis was greater than 50% in all cases. Segmental occlusion of the affected vein was present in 7 ( 14%) cases. Initial percutaneous angioplasty was technically successful in 34(68%) lesions. Suboptimal results from PTA led to stent placement in 8(16%) of lesions.
One year Patency rate for those cases with complete resolvement of symptoms post PTVA and stenting were 25% and for those with PTVA only was 75% with p value that equals 0.7.
One year patency rate for cases that had stenotic nature of lesions was 83.3% and for those who had occlusive nature of lesions was 16.6% with p value that equals 0.8.
Transvenous angioplasty of central venous stenoses is technically successful and safe. Success is achieved only with surveillance and repetitive interventions, which, although frequent, seem to be devoid of major morbidity.