Document Detail

Venous hypertension associated with arteriovenous hemodialysis access.
MedLine Citation:
PMID:  15011180     Owner:  NLM     Status:  MEDLINE    
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.
Richard F Neville; Christopher J Abularrage; Paul W White; Anton N Sidawy
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Review    
Journal Detail:
Title:  Seminars in vascular surgery     Volume:  17     ISSN:  0895-7967     ISO Abbreviation:  Semin Vasc Surg     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-10     Completed Date:  2004-06-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8809602     Medline TA:  Semin Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  50-6     Citation Subset:  IM    
Department of Surgery, VA Medical Center, Washington, DC, USA.
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MeSH Terms
Arteriovenous Shunt, Surgical / adverse effects*,  methods
Catheterization, Central Venous / adverse effects,  methods
Catheters, Indwelling / adverse effects
Constriction, Pathologic
Edema / etiology*,  radiography,  surgery
Follow-Up Studies
Kidney Failure, Chronic / therapy
Renal Dialysis / adverse effects,  methods
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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