Jun Eran Sim Wen, Lun Allen Liu Yan, Nikam Milind
Khoo Teck Puat Hospital, Singapore.
J Vasc Surg Cases Innov Tech. 2017 Mar 22;3(1):20-22. doi: 10.1016/j.jvscit.2016.12.001. eCollection 2017 Mar.
The cephalic arch is a common location of stenosis, especially in brachiocephalic fistulas. The cephalic arch has a number of anatomic variations. Cephalic arch stenoses are often resistant and have poor primary patency. Here we describe an unusual case of a hemodialysis patient with a single-conduit supraclavicular cephalic arch draining into the external jugular vein presenting with recurrent cephalic arch stenoses and external jugular vein stenosis. In our view, extrinsic compression by the clavicle may contribute to the high rate of recurrence, the lack of complete dilation of even high-pressure balloons, and a theoretically heightened risk of rupture when cutting balloons are used.
头臂静脉弓是狭窄的常见部位，尤其是在头臂动静脉内瘘中。头臂静脉弓存在多种解剖变异。头臂静脉弓狭窄往往具有顽固性，且初始通畅率不佳。在此，我们描述了一例不同寻常的血液透析患者病例，该患者的单通道锁骨上头皮静脉弓引流至颈外静脉，出现复发性头臂静脉弓狭窄和颈外静脉狭窄。我们认为，锁骨的外部压迫可能导致高复发率、即使使用高压球囊也无法完全扩张，以及在使用切割球囊时理论上更高的破裂风险。
