Sarala S, Sangeetha B, Mahapatra V S, Nagaraju R D, Kumar A C V, Lakshmi A Y, Ram R, Kumar V S
Department of Radiology, SVIMS, Tirupati, Andhra Pradesh, India.
Department of Nephrology, SVIMS, Tirupati, Andhra Pradesh, India.
Indian J Nephrol. 2018 Jul-Aug;28(4):273-277. doi: 10.4103/ijn.IJN_321_16.
The cephalic vein is formed over the "anatomical snuff box" and joins the axillary vein just below the clavicular level. The definition of cephalic arch is varied. In the radiology literature, it is defined as the central perpendicular portion of the cephalic vein as it traverses the deltopectoral groove and joins the axillary vein. The possible etiologies of cephalic arch stenosis are numerous. This study aimed to identify patients with cephalic arch stenosis and to discern the domain site of stenosis. This is a retrospective case series of patients who had an arteriovenous fistula with dysfunction of access and ipsilateral upper-limb edema. The clinical features of the access dysfunction were strong pulse due to increased pressure, weak thrill due to poor proximal flow, high static pressure, or decreased dialysis efficiency. All these 25 patients underwent computed tomography (CT) angiogram. The CT angiographic findings revealed cephalic arch stenosis and stenosis in 13 patients (52%). domain IV was slightly more affected than other domains of cephalic arch.
头静脉在“解剖鼻烟壶”上方形成，并在锁骨水平稍下方汇入腋静脉。头静脉弓的定义各不相同。在放射学文献中，它被定义为头静脉穿过三角胸肌沟并汇入腋静脉时的中央垂直部分。头静脉弓狭窄的可能病因众多。本研究旨在识别出头静脉弓狭窄的患者，并辨别狭窄的部位。这是一项回顾性病例系列研究，研究对象为患有动静脉内瘘且通路功能障碍和同侧上肢水肿的患者。通路功能障碍的临床特征包括压力升高导致的强脉搏、近端血流不佳导致的微弱震颤、高静水压或透析效率降低。所有这25例患者均接受了计算机断层扫描（CT）血管造影。CT血管造影结果显示，13例患者（52%）存在头静脉弓狭窄和狭窄。IV区比头静脉弓的其他区域受影响稍大。
