Advanced Practice: Thoracic Central Venous Obstruction!
Thoracic Central Venous Obstruction: Stenosis , obstruction, compression, or occlusion of the central chest veins (subclavian, brachiocephalic, SVC)
Etiology in Dialysis Patients
- Repeated venous trauma from central venous catheter placement
- Repeated microtrauma from central venous catheter tips against the vessel wall (with breathing, movement)
- High/turbulent flow from dialysis catheters or same-side fistula
- Ipsilateral arm/neck/face swelling
- CT venography or standard venography (usually via access at the fistula)
- Ultrasonagraphy of the affected extremity may fail to detect
Red circle denotes area of stenosis/occlusion in L brachiocephalic vein
- Balloon venoplasty by interventional radiology
- Mechanical stenting
G Collin, R.G. Jones, A.P Willis. Central Venous Obstruction in the Thorax. Clinical Radiology 2015;70(6): 654-660.