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Abstrak :
Introduction: Central venous stenosis (CVS) or occlusion is a severe complication in hemodialysis patients, which significantly decreases the patency of all vascular dialysis access components, including arteries and branches, AV anastomosis, peripheral veins, and central veins. The main etiology of CVS is mostly secondary to the placement of temporary or permanent dialysis catheters in the subclavian vein, internal jugular vein, and femoral vein. Standard endovascular therapy for central venous stenosis is conventional balloon angioplasty. Method: This is a retrospective study using medical records from June 2013 to August 2018. Patients who underwent plain old balloon angioplasty (POBA) procedures in the CVS condition due to the installation of hemodialysis catheter access were included in this study. The analysis was performed to assess the characteristics and data distribution of each variable. Results: Significant factors related to the success of endovascular procedure in patients with central venous stenosis with POBA were the onset of clinical symptoms (<3 months; p <0.001), duration of catheter placement (<2.5 months; p <0.001), history of previous catheter placement (no more than once, p <0.001), initial stenosis (<80; p <0.001), and diameter of POBA (≥ 10 mm; p <0.001). Conclusion: Some factors influenced the success of the POBA procedure for overcoming CVS. The need to understanding the use of hemodialysis catheter access according to the guideline is important.

Abstrak :
Introduction: Portal hypertension may cause gastrointestinal complications; one of the most serious is a ruptured esophageal varices. Portal hypertension is also the main cause of hypersplenism, which in turn could lead to pancytopenia. Despite adequate therapy, some cases of hypersplenism could not be resolved. Partial splenic embolization (PSE) is an effective alternative method to treat this condition. Method: We reported two cases of hypersplenism treated with PSE. The first case was a 10- year-old girl with pancytopenia and a history of recurrent esophageal ligation. The second case was a 32-year-old man with recurrent episodes of hematemesis for two years before admission. Results: After the PSE procedure, the first patient’s white blood cell and platelet doubled in one month after procedure and stable at follow-up three months later, with no complaint of hematemesis. The second patient’s platelet doubled five days after the procedure. The first patient developed a complication of a splenic abscess, but after antibiotic administration and pus drainage, the condition was resolved. Conclusion: PSE is an effective method to treat hypersplenism secondary to the hypertensive portal. Treatment goals successfully achieved include improvement in blood count and control of bleeding. There are risks following PSE, but with adequate treatment, it can be overcome. Keywords: hypersplenism, partial splenic embolization, portal hypertension, pancytopenia