[Subclavian vein stenosis in hemodialysis patients].

Six haemodialyzed patient are reported in whom subclavian and brachiocephalic vein stenosis secondary to subclavian vein catheterization and to permanent cardiac pacemakers led to massive congestive edema of the same arm after an arteriovenous fistula/grafts were created. In view of the fact that subclavian vein stenosis or occlusion is not associated with any clinical findings and it is not possible to identify any predisposing factors associated with the use of the catheters, all patients who have had previous subclavian vein catheters or with permanent pacemakers should be evaluated to determine the patency of the subclavian vein before creation of a permanent access in that arm. Therapeutic answers as to haemodialysis access are discussed in these patients with permanent pacemakers who need haemodialysis. Because of all of these problems, the practice of subclavian cannulation in patients with end-stage renal failure has been discontinued in our centre. Good and reliable technology is now available for repeated short-term or long-term cannulation of the jugular veins for hemodialysis.