Abstract
A woman in her nineties had been undergoing hemodialysis for four years. She was referred to our hospital because of swelling in her right upper limb where an AV-fistula had been constructed. The swelling around her elbow extended from the forearm to the upper arm. Bruit was heard around the right border of the sternum just below the right clavicle. A central vein stenosis was suspected；therefore, an ultrasound was performed with a portable machine in the outpatient clinic. By setting the linear probe in the right supraclavicular fossa, a right subclavian vein stenosis was visualized in the vicinity of its junction with the right brachiocephalic vein. Enhanced CT was conducted on the same day, which showed the same findings as the ultrasound. Percutaneous transluminal angioplasty was successfully performed five days later. The next day, the swelling and bruit had almost disappeared, and an improvement in the stenosis was also seen on a follow-up ultrasound. The ultrasound-based diagnosis of a central vein stenosis in a deep portion of the body is possible with appropriate ultrasound probe use and training on a routine basis.
