Graft stenosis occurs as a consequence of aggressive myointimal hyperplasia, which occurs most commonly at the venous anastomosis [48]. Vascular injury resulting from the angioplasty may actually accelerate the process of myointimal hyperplasia, thereby resulting in early re-stenosis [49]. Endoluminal stents, by forming a rigid scaffold at the venous anastomosis, may slow the encroachment of the area of myointimal hyperplasia into the vascular lumen, thereby limiting the magnitude of recurrent stenosis. Thus, use of stents may be of utility in preventing restenosis following angioplasty. Stent placement has been attempted for treatment of grafts in which angioplasty results in suboptimal technical success or if the stenosis recurs rapidly. A number of small series have reported the outcomes of stent placement for vascular access with refractory stenosis [50-56]. Unfortunately, these studies have suffered from several methodologic limitations, including retrospective data collection, absence of a suitable control group, combining patent and thrombosed grafts, combining stents placed at a variety of stenotic sites, and combining grafts with fistulas.