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Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2014, Number 3

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Rev Mex Angiol 2014; 42 (3)

Determinación del grado de estenosis de la vena subclavia como predictor en el desarrollo de hipertensión venosa en pacientes sometidos a construcción de fístula arteriovenosa autóloga ipsilateral

Serrato-Auld R, Bizueto-Rosas H

Language: Spanish
References: 25
Page: 119-127
PDF size: 168.47 Kb.


ABSTRACT

Background. The venous hypertension syndrome as a complication of an arteriovenous fistula is linked to ipsilateral central venous stenosis, caused in most cases by hemodialysis catheter placement, which is the inicial vascular access in 77% of patients in México whom start renal function replacement therapy.
Objective. The aim of this study was to determine the degree of subclavian vein stenosis in a preoperative phlebography that can be used to predict venous hypertension development.
Material and methods. A prospective cohort study was done, including 58 patients undergoing construction of AV fistula ipsilateral to the subclavian vein stenosis site that were followed for 6 months with clinical assessment for venous hypertension and vascular access functionality.
Results. 13 of 58 patients developed clinical significant venous hypertension syndrome of which 11 had > 67.5% stenosis, without differences between gender, age, anastomosis diameter, vascular access location or configuration. Only 3 patients required dismantling of AV fistula.
Conclusions. The degree of subclavian vein stenosis may predict the development of clinical significant venous hypertension syndrome when it is greater than 67.5% [PPV 76%, NPV 93.6%, RR 14.24 CI95% (4.69-43.24) p = 0.0000].


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