Venous Hypertension after Internal Arteriovenous Anastomosis on the Forearm for Hemodialysis: Report of 2 Cases / 대한비뇨기과학회지

ABSTRACT

Venous hypertension is caused by the inflow of the arterial blood to the dis-tal venous system due to an obstruction or stenosis of the proximal venous branch in the Patients with internal arteriovenous shunt for hemodialysis. We report the two cases of venous hypertension in patients with internal shunt between the radial artery and the cephalic vein for the first time in Korea. Clinical manifestations were severe pain, swelling, tenderness, hyperpigmentation and ulceration on the involved hand and/or fingers. Venogram showed an obstruction or stenosis of the cephalic vein proximal to the shunt and congestion in the cephalic vein distally. There was no obstruction or stenosis of the ipsilateral subclavian vein. We corrected venous hypert6nsion by ligation of the cephalic vein distal to the shunt and end to end anastomosis between the distal cephalic vein and the basilic vein with interposition of the artificial vessel(Gore-tex(R)). In the follow-up, skin lesions and edema were completely resolved by the second week postoperatively.