SUBCLAVIAN VEIN THROMBOSIS WITH FUNCTIONING DIALYSIS SHUNT IN CHRONIC DIALYSIS PATIENT -A SURGICAL CASE REPORT-

Abstract

This is a case report of left subclavian vein thrombosis in a chronic dialysis patient with functioning brachialmedian A-V fistula of the ipsilateral arm.
A 50-year-old man undergoing continuous hemodialysis for 15 years was admitted to the hospital because of disabled left arm due to severe swelling which developed about one year before and gradually worsened. Phlebography showed total occlusion of the left axillary-subclavian vein and marked development of collateral superficial vein. Left axillary-internal juglar vein bypass was made with a 8 mm ringed E-PTFE graft. In postoperative course, functional disability in the left arm resolved rapidly although swelling of the upper arm remained for several months. Graft patency was confirmed by postoperative phlebography and was indebted to the presence of A-V fistula.
Deep vein thrombosis complicated by A-V fistula in hemodialysis patients usually occurred secondary to central vein (CV) catheterization for temporary blood access. However, in this case there was no history of CV catheterization and the cause of deep vein thrombosis was unclear.