الفهرس 
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Abstract
Central venous stenosis is one of the most common problems which faces the patients of end stage kidney disease on regular haemodialysis and can directly affect the efficacy of the dialysis sessions.
This study included thirty patients with end stage renal disease on regular haemodialysis and was performed at Menoufia University and Kobbry El-Koppa Military Hospital. All patients with functioning AVFs or AVGs were complaining of venous hypertension due to central venous stenosis or obstruction from October 2015 to February 2017.
The commonest cause for central venous stenosis and venous hypertension in this study was the previous cannulation of the central veins by CVCs which was found in 100% of the cases especially the subclavian vein.
In the present study the clinical features of the studied patients were edema in thirty patients (100%), dilated veins chest and neck veins in twenty six patients (86.7%) and pain and hyperesthesia in nine patients (30%), cyanosis in six patients (20%).
Regarding arteriovenous fistula type in the present study they were brachiocephalic fistula in eighteen patients (60%), brachiobasilic fistula in eight patients (26.7%), femoral arteriovenous synthetic grafts in four patients (13.3%) and none of the patients was with radiocephalic fistula
The clinical diagnosis and the cause of venous hypertension were confirmed by duplex scanning and CT venography in more proximal CVS.
In this study, cases were primarily treated by endovascular interventions where PTA was done for 23 patients (76.7%) and stenting for 6 patients (20%) where there was elastic recoil of the vein, restenosis or total occlusion. Primary failure occurred in 7 patients (23.3%) whom had a long segment of total vein occlusion.
Regarding fistula flow rate in the present study, endovascular interventions showed a significant improvement of fistula flow with mean of preoperative fistula flow rate 593 ml/min and 1964 ml/min postoperatively, yielding a mean increase of 1371 ml/min ±552 ml/min.
Complications that occurred during this study were stent migration during its deployment in one patient and stent fracture in one patient also.