Subclavian venous stenosis. A complication of subclavian dialysis
D. Davis, J. Petersen, R. Feldman, C. Cho and C. A. Stevick
Subclavian hemodialysis catheters are widely employed for temporary
hemodialysis access, but there are few reports of serious complications. We
report three cases in which the prolonged (greater than 15 days) use of
subclavian dialysis catheters ipsilateral to the permanent vascular access
was associated with the development of subclavian vein (SCV) stenosis three
to six months after the temporary catheter was removed. In one case, the
use of the permanent access was severely limited by massive arm edema. We
conclude that, in addition to the usual complications of SCV cannulation,
long-term use of SCV hemodialysis catheters can be associated with major
late obstructive complications that may compromise permanent vascular
access. We recommend that, wherever possible, temporary dialysis catheters
and other subclavian lines be placed contralateral to the permanent
vascular access site in patients undergoing hemodialysis.
