Transposition of cephalic vein to rescue hemodialysis access arteriovenous fistula and treat symptomatic central venous obstruction
Autor: | Emerson Hideyoshi Shimada, Felipe Jose Skupien, Suellen Vienscoski Skupien, Rafael Inacio Brandao, Ricardo Zanetti Gomes |
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Rok vydání: | 2014 |
Předmět: |
Cephalic vein
lcsh:Diseases of the circulatory (Cardiovascular) system medicine.medical_specialty business.industry Fistula lcsh:Surgery Arteriovenous fistula lcsh:RD1-811 transposição venosa medicine.disease Venous Obstruction Vein occlusion Surgery bypass venoso enxerto venoso exótico obstrução venosa central lcsh:RC666-701 fístula arteriovenosa cardiovascular system medicine Cardiology and Cardiovascular Medicine business Axillary vein Internal jugular vein External jugular vein |
Zdroj: | Jornal Vascular Brasileiro, Vol 13, Iss 1, Pp 63-66 (2014) |
ISSN: | 1677-7301 1677-5449 |
DOI: | 10.1590/jvb.2014.013 |
Popis: | It is known that stenosis or central venous obstruction affects 20 to 50% of patients who undergo placement of catheters in central veins. For patients who are given hemodialysis via upper limbs, this problem causes debilitating symptoms and increases the risk of loss of hemodialysis access. We report an atypical case of treatment of a dialysis patient with multiple comorbidities, severe swelling and pain in the right upper limb (RUL), few alternative sites for hemodialysis vascular access, a functioning brachiobasilic fistula in the RUL and severe venous hypertension in the same limb, secondary to central vein occlusion of the internal jugular vein and right brachiocephalic trunk. The alternative surgical treatment chosen was to transpose the RUL cephalic vein, forming a venous necklace at the anterior cervical region, bypassing the site of venous occlusion. In order to achieve this, we dissected the cephalic vein in the right arm to its junction with the axillary vein, devalved the cephalic vein and anastomosed it to the contralateral external jugular vein, providing venous drainage to the RUL, alleviating symptoms of venous hypertension and preserving function of the brachiobasilic fistula. |
Databáze: | OpenAIRE |
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