Sierra Nevada Nephrology Consultant; Department of Medicine, University of Nevada Reno School of Medicine, Reno, NV, USA.
Department of Nephrology and Hypertension, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Saudi J Kidney Dis Transpl. 2021 Jan-Feb;32(1):236-239. doi: 10.4103/1319-2442.318531.
A functional arteriovenous access is required to provide hemodialysis, which remains the most commonly used one for renal replacement therapy worldwide. In the upper arm, a brachiocephalic arteriovenous fistula is created by surgically joining the cephalic vein and brachial artery at the elbow. The outflow segment of the cephalic vein near the shoulder is called the cephalic arch. Due to its anatomical location, the cephalic arch segment is prone to developing stenosis resulting in access dysfunction and thrombosis. The management strategy to treat cephalic arch stenosis (CAS) remains a clinical challenge. We report a case of severe CAS treated successfully with endovascular therapy.
需要有功能正常的动静脉通路来提供血液透析，这仍然是全球范围内最常用于肾脏替代治疗的方法。在上臂，通过手术将头静脉和肱动脉在肘部连接起来，形成肱动脉-头静脉动静脉内瘘。靠近肩部的头静脉流出段称为头静脉弓。由于其解剖位置，头静脉弓段容易发生狭窄，导致通路功能障碍和血栓形成。治疗头静脉弓狭窄（CAS）的管理策略仍然是一个临床挑战。我们报告了一例成功通过血管内治疗治疗的严重 CAS 病例。
