Clinical analysis of central venous stenosis In 5 hemodialysis patients without a previous history of catheterization
10.3760/cma.j.issn.1001-7097.2011.03.011
- VernacularTitle:无血液透析插管史的中心静脉狭窄五例临床分析
- Author:
Yaxue SHI
;
Meng YE
;
Hao ZHANG
;
Wei LIANG
;
Jiwei ZHANG
- Publication Type:Journal Article
- Keywords:
Haemodialysis;
Central venous;
Stenosis;
Angioplasty;
Central venous catheterization
- From:
Chinese Journal of Nephrology
2011;27(3):186-189
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate imaging findings and treatment experience in central venous stenosis without a history of previous catheterization in hemodialysis patients. Methods Clinical data of 5 haemodialysis cases of central vein stenosis without a previous catheterization history in our hospital from July 2006 to July 2008 were analyzed retrospectively. Results Patients were three women and two men aged 43 to 65 years with mean age(53±8)years and all had arm swelling as the main complaint.The vascular accesses were located at the wrist in all the patients.The mean duration of the vascular accesses from the time of creation was(33.6±35.4)months.Venography showed occlusion in 2 cases and stenosis in 3 cages of central vein including 1 case of stenosis in brachiocephalic vein.1 case of stenosis beth in branchiocephalic vein and subclavian vein,1 case of stenosis in two segments of subclavian vein.The stenosis of branchiocephalic vein was fixed anterior to the tracheal and CT showed the compression of the vein by the aorta.Symptoms were resolved by the treatment of PTA.subclavian vein-contralateral subclavian vein bypass and ligation of the access. Conclusions Central venous stenosis in haemodialysis patients without a history of catheterization may be due to the intimal hyperplasia of the compression site or valve which is accelerated by the high flow of vascular access.Venography is the first choice for the diagnosis and the current management of central venous stenosis is far from being effective for the long term.
