| Venous hypertension associated with arteriovenous hemodialysis access. | |
MedLine Citation:
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PMID: 15011180 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Venous hypertension is a significant problem for the patient on chronic hemodialysis. This condition can result in impairment of arteriovenous access function, disabling upper extremity edema with bluish discoloration and pigmentation of the skin, and, in advanced cases, ulceration of the finger tips and neuralgias. Venous hypertension usually results from central vein stenosis or valvular incompetence in the arteriovenous access outflow vein. A high index of suspicion is required to identify patients at risk for venous hypertension. A history of ipsilateral central venous catheter placement, or physical signs such as visible distended shoulder venous collaterals, and upper extremity edema are suggestive. Diagnosis is confirmed with Duplex ultrasound or contrast venography. The primary goal of diagnosis and therapy of venous hypertension is symptomatic relief while maintaining the functionality of the access. Treatment includes percutaneous catheter-based and open surgical techniques. Open surgical techniques, while more invasive, remain the gold standard as long-term patency after angioplasty, with or without covered stents, remains unproven. |
Authors:
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Richard F Neville; Christopher J Abularrage; Paul W White; Anton N Sidawy |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Review |
Journal Detail:
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Title: Seminars in vascular surgery Volume: 17 ISSN: 0895-7967 ISO Abbreviation: Semin Vasc Surg Publication Date: 2004 Mar |
Date Detail:
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Created Date: 2004-03-10 Completed Date: 2004-06-15 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8809602 Medline TA: Semin Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 50-6 Citation Subset: IM |
Affiliation:
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Department of Surgery, VA Medical Center, Washington, DC, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Arteriovenous Shunt, Surgical
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adverse effects*,
methods Catheterization, Central Venous / adverse effects, methods Catheters, Indwelling / adverse effects Constriction, Pathologic Edema / etiology*, radiography, surgery Female Follow-Up Studies Humans Kidney Failure, Chronic / therapy Male Phlebography Renal Dialysis / adverse effects, methods Reoperation Risk Assessment Subclavian Vein / physiopathology* Treatment Outcome Venous Pressure* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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