Superior vena cava stenosis associated with hemodialysis catheters

Abstract

The cases are described of four patients on long-term hemodialysis who developed stenosis of the superior vena cava (SVC) that interfered with the functioning or placement of jugular catheters for hemodialysis. All four patients had previously received multiple subclavian and/or jugular catheters inserted for hemodialysis access. In three patients, the SVC stenosis was successfully dilated by balloon angioplasty, and in one of these a stent was inserted to prevent restenosis. These three patients have subsequently been successfully dialyzed with jugular catheters. Stenosis of the SVC should be suspected when jugular catheters in the SVC give inadequate flows in the absence of thrombotic obstruction. Balloon dilatation with or without vascular stenting may allow satisfactory vascular access to be reestablished.