A case in which increasing the outer diameter of the venous needle was found to be effective at treating intimal hyperplasia and stenosis

Abstract

One of the causes of arteriovenous fistula stenosis is intimal hyperplasia. Intimal hyperplasia has been attributed to turbulent flow. It has not been determined whether the outer diameter of venous dialysis needles affects the risk of intimal hyperplasia in dialysis patients. The patient was diagnosed with intimal hyperplasia in the upper arm, away from the venous return site, and vascular access intervention therapy (VAIVT) was performed frequently. Since the associated stenosis was located away from the venous return site, we suspected that it had been caused by turbulent flow from the venous dialysis needle. Therefore, we subsequently performed hemodialysis using a venous needle with a larger outer diameter in order to reduce turbulent flow. As a result, we were able to suppress the progression of the intimal hyperplasia‒induced vascular stenosis and prolong the interval between each round of VAIVT. Using venous needles with larger outer diameters for dialysis may be an effective way of suppressing intimal hyperplasia‒induced stenosis of the upper arm at locations away from the venous return site.