[Surgical treatment of patients with superior vena cava syndrome associated with permanent vascular access].

Presented herein are two clinical case reports concerning surgical treatment for superior vena cava syndrome in patients suffering from end-stage renal disease and undergoing programmed haemodialysis. Initially attempted roentgen-endovascular recanalization turned out to be unsuccessful. The patients were then subjected to ipsilateral extrathoracic bypass grafting, which made it possible to preserve the vascular access for programmed haemodialysis and to relieve venous hypertension of the limb and the brain, as well as to improve quality of life. In one case, the duration of graft patency amounted to 6 months, during which time collateral circulation developed, with no relapse of venous hypertension observed, and the access functioned for a further 14 months. Thus, survival of the permanent vascular access increased by 20 months. In the second case, the duration of graft patency and functionality of the vascular access at the time of writing this article amounted to 12 months.