Surgical Management for Venous Obliteration Due to Subclavian Dialysis Catheter

Abstract

Percutaneous subclavian vein catheter hemodialysis has been accepted as a convienient method in acute need of hemodialysis, but recently, as a serious complication, not a few cases of venous obliterations were reported. Patients on hemodialysis with a functioning arteriovenous fistula become symptomatic with venous hypertension and painful edema. As fistula ligation renders the arm unsuitable for future blood access, venous reconstruction should be considered. In our series, two patients with right subclavian vein obstruction and innominate vein stenosis were treated by polytetrafluoroethylene bypass graft and by angioplasty, respectively. Their symptoms disappeared, and fistulas were preserved for 6 and 25 months.