PMID- 7865390
OWN - NLM
STAT- MEDLINE
DCOM- 19950330
LR  - 20220331
IS  - 0890-5096 (Print)
IS  - 0890-5096 (Linking)
VI  - 8
IP  - 6
DP  - 1994 Nov
TI  - Proximal venous outflow obstruction in patients with upper extremity 
      arteriovenous dialysis access.
PG  - 530-5
AB  - To evaluate the impact of central venous obstruction on upper extremity 
      hemodialysis access failure, we retrospectively analyzed our recent experience in 
      managing this problem. We reviewed 158 upper extremity hemodialysis access 
      procedures performed in 122 patients during a 1-year period. Fourteen (11.5%) 
      patients had central vein obstruction as the cause of severe arm swelling, graft 
      thrombosis, or graft malfunction. All 14 patients had had bilateral temporary 
      subclavian vein dialysis catheters and failed upper extremity arteriovenous 
      access. Seventeen lesions were treated in 14 patients including eight subclavian 
      vein occlusions, six subclavian vein stenoses, two internal jugular vein 
      stenoses, and one superior vena cava stenosis. Twenty-one procedures were 
      performed including 17 percutaneous transluminal balloon angioplasties (PTAs) 
      with stent placement in 13, two axillary to innominate vein bypasses, and two 
      axillary to internal jugular vein bypasses. All patients had resolution of 
      symptoms. Thirteen (76%) PTAs were initially successful but in four (24%) cases 
      it was impossible to recanalize the vein. Eight (47%) PTAs provided functional 
      hemodialysis access for 2 to 9 months, two (12%) restenosed at 3 and 10 months 
      and were successfully redilated, two occluded at 2 and 4 months and were unable 
      to be recanalized, and one failed immediately after a successful PTA. Four PTA 
      failures were followed by venous bypass, which remained patent and provided 
      functional access 7 to 13 months after surgery. Of nine stenotic venous lesions 
      six (67%) were successfully dilated without restenosis, whereas of eight occluded 
      veins only two (25%) were successfully treated without recurrence. Temporary 
      central hemodialysis catheters produce a significant number of symptomatic 
      central vein obstructions in patients with upper extremity arteriovenous 
      access.(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - Criado, E
AU  - Criado E
AD  - Division of Vascular Surgery, University of North Carolina at Chapel Hill School 
      of Medicine.
FAU - Marston, W A
AU  - Marston WA
FAU - Jaques, P F
AU  - Jaques PF
FAU - Mauro, M A
AU  - Mauro MA
FAU - Keagy, B A
AU  - Keagy BA
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
SB  - IM
MH  - Angioplasty, Balloon
MH  - Arm/*blood supply
MH  - Arteriovenous Shunt, Surgical/*adverse effects
MH  - Axillary Vein/surgery
MH  - Brachiocephalic Veins/surgery
MH  - Catheters, Indwelling/*adverse effects
MH  - Constriction, Pathologic/etiology/therapy
MH  - Female
MH  - Graft Occlusion, Vascular/*etiology/therapy
MH  - Humans
MH  - Jugular Veins/pathology/surgery
MH  - Male
MH  - Middle Aged
MH  - Recurrence
MH  - *Renal Dialysis
MH  - Reoperation
MH  - Retrospective Studies
MH  - Stents
MH  - Subclavian Vein/pathology/surgery
MH  - Thrombosis/etiology/therapy
MH  - Treatment Failure
MH  - Vena Cava, Superior/pathology/surgery
EDAT- 1994/11/01 00:00
MHDA- 1994/11/01 00:01
CRDT- 1994/11/01 00:00
PHST- 1994/11/01 00:00 [pubmed]
PHST- 1994/11/01 00:01 [medline]
PHST- 1994/11/01 00:00 [entrez]
AID - S0890-5096(06)60388-9 [pii]
AID - 10.1007/BF02017408 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 1994 Nov;8(6):530-5. doi: 10.1007/BF02017408.