Skandalou Eleni I, Apostolidou-Kiouti Fani D, Minasidis Ilias D, Skandalos Ioannis K
Renal Unit "Therapeutiki", Thessaloniki, Greece.
Surgical Department, General Hospital "Agios Pavlos", Thessaloniki, Greece.
Case Rep Vasc Med. 2017;2017:9524739. doi: 10.1155/2017/9524739. Epub 2017 Oct 22.
Central vein stenosis/occlusion is a common well-described sequel to the placement of hemodialysis catheters in the central venous system. The precise mechanisms by which central vein stenosis occurs are not well known. Current concepts in central vein stenosis pathophysiology focus on the response to vessel injury model, emphasizing the process of trauma. A case of left brachiocephalic vein stenosis due to the insertion and function of a temporary right subclavian hemodialysis catheter is presented. The purpose of the manuscript is to emphasize that, with the introduction of a temporary subclavian hemodialysis catheter via the right subclavian vein apart from causing concurrent stenosis/infarction of the right subclavian and right brachiocephalic vein, it is also possible to cause stenosis of the left brachiocephalic vein (close to its contribution to the superior vena cava) although the catheter tip is placed in the correct anatomical position in the superior vena cava.
中心静脉狭窄/闭塞是血液透析导管置入中心静脉系统后常见且描述详尽的后遗症。中心静脉狭窄发生的确切机制尚不清楚。目前关于中心静脉狭窄病理生理学的概念集中在对血管损伤模型的反应上，强调创伤过程。本文介绍了一例因临时右锁骨下血液透析导管的置入及功能导致左头臂静脉狭窄的病例。本文的目的是强调，经右锁骨下静脉置入临时锁骨下血液透析导管，除了会同时导致右锁骨下静脉和右头臂静脉狭窄/梗死外，尽管导管尖端置于上腔静脉的正确解剖位置，但也有可能导致左头臂静脉（靠近其汇入上腔静脉处）狭窄。
