Jurabek Babadjanov1, Rick Bernstein2, Lee Kirksey1. 1. Vascular Surgery Department, Cleveland Clinic, Cleveland, OH - USA. 2. Advanced Vein Treatment Center, North Las Vegas, NV - USA.
Abstract
BACKGROUND: Central vein thrombosis or obstruction is a common complication associated with central venous catheters placed for intermittent hemodialysis. The reported outcomes of percutaneous catheter-based interventions reveal high rates of lesion recurrence with varying and frequently limited patency intervals. We present the case of open venous bypass in the treatment of catheter-associated chronic central vein occlusion. METHODS: We report a case of symptomatic arm swelling secondary to central vein stenosis and failed endovascular venous intervention treated by central vein bypass with prosthetic graft through median sternotomy. RESULTS: Patient had an open axillary to innominate venous bypass via median sternotomy incision, which resulted in resolution of patient's symptoms and uninterrupted patency of the pre-existing vascular access. CONCLUSIONS: Open venous bypass is a reliable alternative to endovascular intervention in the symptomatic patient with extensive central vein occlusion as a primary intervention or in whom prior endovascular therapy has failed.
BACKGROUND: Central vein thrombosis or obstruction is a common complication associated with central venous catheters placed for intermittent hemodialysis. The reported outcomes of percutaneous catheter-based interventions reveal high rates of lesion recurrence with varying and frequently limited patency intervals. We present the case of open venous bypass in the treatment of catheter-associated chronic central vein occlusion. METHODS: We report a case of symptomatic arm swelling secondary to central vein stenosis and failed endovascular venous intervention treated by central vein bypass with prosthetic graft through median sternotomy. RESULTS:Patient had an open axillary to innominate venous bypass via median sternotomy incision, which resulted in resolution of patient's symptoms and uninterrupted patency of the pre-existing vascular access. CONCLUSIONS: Open venous bypass is a reliable alternative to endovascular intervention in the symptomatic patient with extensive central vein occlusion as a primary intervention or in whom prior endovascular therapy has failed.