Surgical management of subclavian and axillary vein thrombosis in patients with a functioning arteriovenous fistula
Until recently, secondary thrombosis of the deep veins of the upper extremity was rarely encountered. The expanding use of the subclavian vein as a route to the central circulation has increased its occurrence, but symptoms are uncommon. Patients on hemodialysis with a functioning arteriovenous fistula become symptomatic with venous hypertension and swelling. Treatment becomes necessary, and fistula ligation is usually recommended; however, this renders the extremity unsuitable for a future life-sustaining access. Patency of grafts in the venous system has been accomplished with a temporary arteriovenous fistula. In six patients with chronic renal failure and a functioning arteriovenous fistula, a polytetrafluoroethylene graft was used to replace or bypass the obstructed vein. Symptoms resolved, and the fistula was preserved in three of the six patients for 1 to 3 years.
Currier, C., Widder, S., Ali, A., Kuusisto, E., & Sidawy, A. (1986). Surgical management of subclavian and axillary vein thrombosis in patients with a functioning arteriovenous fistula. Surgery, 100 (1). Retrieved from https://hsrc.himmelfarb.gwu.edu/smhs_surgery_facpubs/1670