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Massive arm edema following arteriovenous dialysis shunt creation in a patient with ipsilateral permanent pacemaker
Author(s) -
Maher James,
Rivero Abel,
Zaim Sina,
Pappas Peter J.,
Labropoulos Nicos,
Klapholz Marc,
Saric Muhamed
Publication year - 2008
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.20405
Subject(s) - medicine , asymptomatic , subclavian vein , hemodialysis , shunt (medical) , surgery , occlusion , edema , hemodialysis access , radiology , vascular access , catheter
Asymptomatic subclavian vein occlusion following insertion of a permanent pacemaker (PPM) or implantable cardioverter‐defibrillator (ICD) is not uncommon. We report a case of a dual‐chamber PPM in a patient with an unrecognized left subclavian vein occlusion who developed massive left arm edema following ipsilateral implantation of an arteriovenous (AV) hemodialysis graft. We recommend that patients with pre‐existing PPM or ICD leads who are in need of vascular access for hemodialysis should have the AV shunts placed in the contralateral arm. If this is unavoidable, then preoperative subclavian vein screening for patency should be mandatory, even in asymptomatic patients. Sonography is an appropriate initial test in such a situation. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2008