Open AccessKilling Two Birds with One Stone: Subclavian Vein Bypass Graft for Relief of Venous Obstruction and Haemodialysis Access
Author(s) -
Kar Wee Koh,
Jendana Chanyaputhipong,
Seck Guan Tan
Publication year - 2012
Publication title -
proceedings of singapore healthcare
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.21
H-Index - 9
eISSN - 2059-2329
pISSN - 2010-1058
DOI - 10.1177/201010581202100308
Subject(s) - medicine , basilic vein , surgery , angioplasty , arteriovenous fistula , subclavian vein , occlusion , fistula , subclavian artery , vein , brachiocephalic vein , dialysis , ligation , cephalic vein , catheter , stenosis , hemodialysis , dialysis catheter , complication , internal jugular vein , radiology , superior vena cava
Subclavian and brachio-cephalic vein stenosis or occlusion occurs, most commonly, as an iatrogenic complication of the placement of central venous catheter. This occurrence can cause ipsilateral arm swelling in a newly-created arteriovenous fistula (AVF). Critical central vein stenoses are often successfully managed by endovascular approach; occasionally, complete occlusion with symptomatic severe arm swelling and pain that does not respond to angioplasty requires ligation of the dialysis access. We report successful surgical management of an end-stage-renal-failure (ESRF) patient with symptomatic subclavian vein occlusion refractory to angioplasty in an ipsilateral arm with an existing functional brachio-basilic transposition arteriovenous fistula by performing a basilic to internal jugular vein (IJV) bypass graft, relieving both the arm swelling and salvaging the existing vascular access for future haemodialysis.