Reconstruction of Obstructive Venous Disease in Arteriovenous Access

Abstract

The obstructive venous lesions in patients in arterio-venous access were studied retrospectively. From April 1996 to March 2000, 10 reconstructions for the obstructive venous lesions were performed in 5 patients with functioning arterio-venous hemodialysis shunt. Four were men and one was woman, age ranging from 62 to 78 (average 68.2) years old. The complaints were low flow of the shunt access in 2 patients and arm edema with pulsatile pain in 3 patients. The diseased veins were 3 cephalic veins of forearm, 3 cephalic veins of upperarm, 3 subclavian veins and 1 innominate vein. Three veno-venous anastomoses, 1 interposing, 1 patch-angioplasty, 3 balloon angioplasty and 2 bypasses were performed. They improved after the procedures. The evaluation of the outflow vein tract is important before arterio-venous accessing, especially for the patients who had the history of cannulation of the blood access catheter. The extraanatomical bypass with prosthesis can be of successful procedure for the obstruction of subclavian or innominate vein.