Costoclavicular Venous Decompression in Patients With Threatened Arteriovenous Hemodialysis Access

Glass, Carolyn; Dugan, Michelle; Gillespie, David L.; Doyle, Adam J.; Illig, Karl A.

doi:10.1016/j.avsg.2010.12.020

Cited by 38 publications

(18 citation statements)

References 28 publications

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“…Simple venoplasty in this setting is unlikely to provide a long-term solution. This not only is demonstrated in our first case but also is echoed by Glass et al, 12 who in their series had six patients who had unsuccessful venoplasty before requiring surgical decompression.…”

Section: Discussionsupporting

confidence: 80%

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First rib removal and decompression of the thoracic outlet as an indication to facilitate hemodialysis

McHugh

Hussain

Aljabri

et al. 2016

Journal of Vascular Surgery Cases, Innovations and Techniques

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We present two cases of thoracic outlet decompression performed to facilitate hemodialysis through upper limb arteriovenous fistulas. In patients undergoing arteriovenous fistula formation for dialysis access, venous hypertension is a well-known complication. We used a supraclavicular approach in our two reported cases to remove the first rib to facilitate hemodialysis. Dialysis patients presenting with central venous stenosis should be assessed for evidence of extrinsic compression by the first rib as management options differ from those with central venous stenosis due to an intravenous catheter. (J Vasc Surg Cases 2016;2:111-3.)

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Section: Discussionsupporting

confidence: 80%

“…In addition, a series of 10 patients with AVF dysfunction underwent intervention for extrinsic subclavian vein compression. 12 In this cohort, six patients underwent first rib resection through a transaxillary approach. Overall fistula salvage rate in this cohort was 80%.…”

Section: Discussionmentioning

confidence: 99%

First rib removal and decompression of the thoracic outlet as an indication to facilitate hemodialysis

McHugh

Hussain

Aljabri

et al. 2016

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…We began treating such patients with aggressive thoracic outlet decompression in 2008, and were able to salvage 80% of fistulae that were deemed otherwise unsalvageable. 4,5 Taking lessons learned from that experience and following relocation of the primary author (K.A.I. ), we began aggressively treating such patients in the Tampa Bay region in 2012.…”

Section: Introductionmentioning

confidence: 99%

Aggressive Costoclavicular Junction Decompression in Patients with Threatened AV Access

Illig

Gabbard²,

Calero

et al. 2015

Annals of Vascular Surgery

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“…The adjacent cephalic arch presents a similar dilemma for getting adequate blood flow past the costoclavicular junction in cases refractory to endovascular treatment. Small series of surgical treatments for costoclavicular and cephalic arch stenosis and occlusion have been reported and include first rib resection, claviculectomy, jugular vein turndown, cephalic vein transposition, bypass, and HeRO graft (Merit Medical, Jordon, Utah) placement (3)(4)(5)(6). The costoclavicular bypass is a minimally invasive alternative to surgery using a percutaneous subcutaneous bypass around the costoclavicular junction using commercially available stent grafts.…”

mentioning

confidence: 99%

Percutaneous Costoclavicular Bypass for Thoracic Outlet Syndrome and Cephalic Arch Occlusion in Hemodialysis Patients

Hull

Snyder

2019

Journal of Vascular and Interventional Radiology

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Purpose: To report results of percutaneous costoclavicular bypass for symptomatic thoracic outlet or cephalic arch occlusion in patients with arteriovenous fistula. Materials and Methods: A retrospective review of percutaneous costoclavicular bypass patients between 2014 and 2018 was performed. Stent grafts were placed subcutaneously over the clavicle from the fistula outflow (axillary or cephalic vein) into a jugular vein or collateral. The procedures were performed in patients who had exhausted or were not candidates for balloon dilation or intravascular stent placement. Results: Technical success was 100% (9/9) with resolution of symptoms in all patients. Indications were arm swelling in 67% (6/9), fistula dysfunction in 22% (2/7), and 1 enlarging aneurysm. The fistula outflow was cephalic in 67% (6/9) and axillary in 33% (3/9). The return vessel was external jugular in 78% (7/9) and internal jugular in 22% (2/9). Two overlapping Viabahn stent grafts were used in 88% of cases (7/8) and 3 stent grafts in 1 case. In the initial case, 2 Gore hybrid grafts were used. Stent graft diameter ranged from 9 mm to 13 mm. Mean follow-up was 852 ± 339 days (range, 488-1483 days). At 12 months and 24 months, primary patency was 67% and 67%, and secondary patency was 89% and 78%, respectively. Complications included late thrombosis and secondary infection. There were no anastomotic leaks or seromas associated with extravascular stent grafts. Conclusions: The percutaneous costoclavicular bypass is a feasible option for thoracic outlet and cephalic arch occlusion in symptomatic dialysis patients.

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Costoclavicular Venous Decompression in Patients With Threatened Arteriovenous Hemodialysis Access

Cited by 38 publications

References 28 publications

First rib removal and decompression of the thoracic outlet as an indication to facilitate hemodialysis

First rib removal and decompression of the thoracic outlet as an indication to facilitate hemodialysis

Aggressive Costoclavicular Junction Decompression in Patients with Threatened AV Access

Percutaneous Costoclavicular Bypass for Thoracic Outlet Syndrome and Cephalic Arch Occlusion in Hemodialysis Patients

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