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Central venous stenosis

Xiang-Yang Li, Hai-Yan He, Pearl Pai
Central venous catheterization can be challenging in patients that had undergone repeated catheter placements. Ultrasound scan may overlook venous stenosis which is better visualized using venography. The use of venography should be considered to assess for venous stenosis or vascular anomalies in individuals with multiple catheterizations or in close proximity to cancer.
March 2018: Clinical Case Reports
Yuki Horita
The objectives of central venous percutaneous transluminal angioplasty are to dilate the venous lesion and to extend the life of arteriovenous fistula for hemodialysis. It is reasonable to perform percutaneous transluminal angioplasty for central venous lesions if this interventional therapy is required to maintain stable dialysis therapy. However, the presence of large fresh thrombus at central venous lesion site represents a contraindication to percutaneous transluminal angioplasty unless the thrombus can first be removed by thrombectomy...
March 1, 2018: Journal of Vascular Access
Nianfang Lu, Li Jiang, Bo Zhu, Wenyong Han, Yingqi Zhao, Yuntao Shi, Fashuang Guo, Xiuming Xi
OBJECTIVE: To explore the accuracy of fluid responsiveness assessment by variability of peripheral arterial peak velocity and variability of inferior vena cava diameter (ΔIVC) in patients with septic shock. METHODS: A prospective study was conducted. The patients with septic shock undergoing mechanical ventilation (MV) admitted to intensive care unit (ICU) of Beijing Electric Power Hospital from January 2016 to December 2017 were enrolled. According to sepsis bundles of septic shock, volume expansion (VE) was conducted...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Eric Pillado, Mina Behdad, Russell Williams, Samuel E Wilson
INTRODUCTION: Construction of radiocephalic AV fistula (RC- AVF) results in successful hemodialysis (HD) in approximately 40 percent of ESRD patients. We investigated whether RC-AVF flow measured by ultrasound 30 days postoperative predicted successful HD. METHODS: In this prospective study color Doppler ultrasound (DUS) was used to measure cephalic vein outflow volume at three forearm sites one and three months postoperative. RESULTS: Of 45 consecutive patients screened for feasibility of RC-AVF by physical exam and US arterial and vein mapping, 41 were considered suitable for construction of RC-AVF...
February 22, 2018: Annals of Vascular Surgery
J M Fichelle, V Baissas, S Salvi, J N Fabiani
Superior vena cava (SVC) stenosis or thrombosis is a well-known complication of central venous catheterization for endocavitary treatments, hemodialysis, or chemotherapy. In cancer patients, these SVC lesions are often symptomatic due to intimal damage and chemotherapy toxicity. We report our experience with six patients treated between 2007 and 2012 via an endovascular approach (n=5) or a direct surgical approach (n=1). All patients had SVC syndrome with facial edema, headache and upper limb edema. In three cases, the catheter was in place when the clinical symptoms occurred...
February 2018: Journal de Médecine Vasculaire
Vedran Premuzic, Lea Katalinic, Marijan Pasalic, Hrvoje Jurin
Cardiac tamponade caused by perforation of the cardiac wall is a rare complication related to central venous catheter (CVC) placement. A 71-year-old female with a previous history of moderate aortic stenosis and kidney transplantation was admitted to hospital due to global heart failure and worsening of allograft function. Intensified hemodialysis was commenced through a CVC placed in the right subclavian vein. Chest radiography revealed catheter tip in the right atrium and no signs of pneumothorax. Thorough diagnostics outruled immediate life-threatening conditions, such as myocardial infarction and pulmonary embolism...
January 2018: Saudi Journal of Anaesthesia
Juan C Duque, Marwan Tabbara, Laisel Martinez, Angela Paez, Guillermo Selman, Loay H Salman, Omaida C Velazquez, Roberto I Vazquez-Padron
BACKGROUND: Intimal hyperplasia has been historically associated with improper venous remodeling and stenosis after creation of an arteriovenous fistula. Recently, however, we showed that intimal hyperplasia by itself does not explain the failure of maturation of 2-stage arteriovenous fistulas. We seek to evaluate whether intimal hyperplasia plays a role in the development of focal stenosis of an arteriovenous fistula. METHODS: This study compares intimal hyperplasia lesions in stenotic and nearby nonstenotic segments collected from the same arteriovenous fistula...
December 11, 2017: Surgery
H J Mehta
No abstract text is available yet for this article.
November 2017: Indian Journal of Nephrology
Eleni I Skandalou, Fani D Apostolidou-Kiouti, Ilias D Minasidis, Ioannis K Skandalos
Central vein stenosis/occlusion is a common well-described sequel to the placement of hemodialysis catheters in the central venous system. The precise mechanisms by which central vein stenosis occurs are not well known. Current concepts in central vein stenosis pathophysiology focus on the response to vessel injury model, emphasizing the process of trauma. A case of left brachiocephalic vein stenosis due to the insertion and function of a temporary right subclavian hemodialysis catheter is presented. The purpose of the manuscript is to emphasize that, with the introduction of a temporary subclavian hemodialysis catheter via the right subclavian vein apart from causing concurrent stenosis/infarction of the right subclavian and right brachiocephalic vein, it is also possible to cause stenosis of the left brachiocephalic vein (close to its contribution to the superior vena cava) although the catheter tip is placed in the correct anatomical position in the superior vena cava...
2017: Case Reports in Vascular Medicine
Voranaddha Vacharathit, Steven D Billings, Lee Kirksey
INTRODUCTION: Arteriovenous fistulae (AVF)-associated reactive angioendotheliomatosis (RAE) is a very rare entity (three previously reported cases in the literature) that can manifest as extremity wounds. RAE's etiopathology is unknown. CASE DESCRIPTION: We report a case of severe limb-threatening upper extremity wound with pathology-proven RAE. This lesion was previously refractory to standard wound care. There was no evidence of limb ischemia or steal syndrome, previously deemed to be the underlying cause of AVF-associated RAE in other reports...
November 25, 2017: Journal of Vascular Access
Melissa S W Yamauchi, Mary Hunt Martin, Harlan R Muntz, Ronald W Day
Hemoptysis may occur in patients with pulmonary venous obstruction and prominent decompressing vessels in the airways adjacent to the affected pulmonary veins. The options for treatment of hemoptysis are limited, particularly when efforts to alleviate pulmonary venous obstruction have failed. Here we describe a patient with hemoptysis associated with stenosis of the central left upper pulmonary vein and occlusion of the central left lower pulmonary vein. The left upper pulmonary vein was dilated with balloon catheters and a vascular plug was placed in the left lower pulmonary artery...
2017: Respiratory Medicine Case Reports
Vikas Kapil, Paul A Sobotka, Mel D Lobo, Roland E Schmieder
PURPOSE OF REVIEW: Novel, interventional treatments have emerged in the last decade for the treatment of resistant hypertension. This review focuses on a unique device that creates a fixed calibre, central iliac arteriovenous anastomosis that is significantly different in haemodynamic and safety profile from traditional haemodialysis fistulae. The background, physiology, and clinical data to date will be presented. RECENT FINDINGS: The single, randomized, controlled clinical trial using the ROX coupler in patients with resistant hypertension demonstrated substantial reductions in both office and ambulatory blood pressure to 12-month postimplantation...
January 2018: Current Opinion in Nephrology and Hypertension
Martin Huecker, Zach Harris, Eric Yazel
BACKGROUND: Achondroplastic dwarfism is associated with anatomic abnormalities that can predispose to occult injury and challenges in trauma management. Airway anatomy is problematic due to macrocephaly, midface hypoplasia, and a narrow nasopharynx. Manipulation of the neck is very dangerous due to the high likelihood of preexisting cervicomedullary stenosis. Restrictive lung disease and obstructive sleep apnea may complicate respiratory status. Peripheral and central venous access can be difficult to obtain...
October 2017: Journal of Emergency Medicine
Menfil Orellana-Barrios, Nachiket Patel, Aliakbar Arvandi, Ralph Paone, Dixon Santana
Venous stents (VS) are used to treat central and peripheral stenoses. Stent embolization into a cardiac chamber is a rare, yet serious complication. We present a case of a 61-year-old man with a recently stented arteriovenous graft venous stenosis who developed VS migration into the right ventricle, associated with S. aureus bacteremia.
August 19, 2017: Curēus
Melvin D Lobo, Christian Ott, Paul A Sobotka, Manish Saxena, Alice Stanton, John R Cockcroft, Neil Sulke, Eamon Dolan, Markus van der Giet, Joachim Hoyer, Stephen S Furniss, John P Foran, Adam Witkowski, Andrzej Januszewicz, Danny Schoors, Konstantinos Tsioufis, Benno J Rensing, Benjamin Scott, G André Ng, Roland E Schmieder
Creation of a central iliac arteriovenous anastomosis using a novel nitinol coupler device results in an immediate, significant reduction of blood pressure (BP). We present efficacy and safety findings at 12 months post-coupler insertion. This open-label, multicenter, prospective, randomized trial enrolled patients with a baseline office systolic BP ≥140 mm Hg and average daytime ambulatory BP ≥135/85 mm Hg. Subjects were randomly allocated to coupler implantation and continuing previous pharmacotherapy or to maintain previous treatment alone...
December 2017: Hypertension
Seshadri Raju, William Crim, William Buck
BACKGROUND: Peripheral venous hypertension and microvascular injury have merged as central features of chronic venous disease. Peripheral venous pressure in the lower limb is controlled by central and peripheral mechanisms. In the current manuscript, we examine the role of peripheral factors, particularly conduit capacitance compliance, focal stenosis, and arterial inflow into the calf. METHODS: An experimental venous model using Penrose tubing as a venous analogue was used where the aforementioned parameters could be manipulated...
November 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Mehrdad Ghahremani-Ghajar, Anna Jin, Peyman Borghei, Joline L T Chen
Hemodialysis catheters are associated with higher risks of complications compared to arteriovenous fistulas and grafts. Some common complications of dialysis catheters include infection, thrombus formation, central venous stenosis, and mechanical dysfunction. Rarely, catheters can become firmly adhered to a vessel wall. Catheter adhesion is a serious complication that can impact the delivery of safe and effective dialysis to affected patients. Adherent catheters commonly present insidiously with no overt diagnostic signs and symptoms or antecedent catheter malfunction...
August 30, 2017: Hemodialysis International
Rezo Jorbenadze, Johannes Patzelt, Meinrad Gawaz, Peter Seizer, Harald F Langer
Percutaneous edge-to-edge mitral valve repair (PMVR) is widely used for selected, high-risk patients with severe mitral valve regurgitation (MR). This report describes a case of 81-year-old woman presenting with severe and highly symptomatic mitral valve regurgitation (MR) caused by a flail of the posterior mitral valve leaflet (PML). PMVR turned out to be challenging in this patient because of a stenosis and tortuosity of both iliac veins as well as sclerosis of the interatrial septum, precluding the vascular and left atrial access by standard methods, respectively...
2017: Case Reports in Cardiology
Jarrod E Ehrie, Therese E Sammarco, Jesse L Chittams, Scott O Trerotola
PURPOSE: To determine the frequency of new-onset symptoms of central venous stenosis (CVS) after percutaneous transluminal angioplasty (PTA) of a hemodialysis access-related stenosis in patients with previously asymptomatic CVS and to identify risk factors for this phenomenon. MATERIALS AND METHODS: Retrospective review was performed of patients treated with PTA for an access-related stenosis (excluding central vein interventions) between 2001 and 2016 who returned within 3 months with symptoms of CVS (ie, "unmasking"): 39 patients met these criteria...
October 2017: Journal of Vascular and Interventional Radiology: JVIR
Johnathon C Rollo, Steven M Farley, Adam Z Oskowitz, Karen Woo, Brian G DeRubertis
OBJECTIVE: Patients with May-Thurner syndrome (MTS) present with a spectrum of findings ranging from mild left leg edema to extensive iliofemoral deep venous thrombosis (DVT). Whereas asymptomatic left common iliac vein (LCIV) compression can be seen in a high proportion of normal individuals on axial imaging, the percentage of these persons with symptomatic compression is small, and debate exists about the optimal clinical and diagnostic criteria to treat these lesions in patients with symptomatic venous disease...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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