Davis D, Petersen J, Feldman R, Cho C, Stevick C A
JAMA. 1984 Dec 28;252(24):3404-6. doi: 10.1001/jama.252.24.3404.
Subclavian hemodialysis catheters are widely employed for temporary hemodialysis access, but there are few reports of serious complications. We report three cases in which the prolonged (greater than 15 days) use of subclavian dialysis catheters ipsilateral to the permanent vascular access was associated with the development of subclavian vein (SCV) stenosis three to six months after the temporary catheter was removed. In one case, the use of the permanent access was severely limited by massive arm edema. We conclude that, in addition to the usual complications of SCV cannulation, long-term use of SCV hemodialysis catheters can be associated with major late obstructive complications that may compromise permanent vascular access. We recommend that, wherever possible, temporary dialysis catheters and other subclavian lines be placed contralateral to the permanent vascular access site in patients undergoing hemodialysis.
锁骨下静脉血液透析导管广泛用于临时血液透析通路，但严重并发症的报道较少。我们报告了3例病例，在拔除临时导管后3至6个月，同侧永久性血管通路长期（超过15天）使用锁骨下透析导管与锁骨下静脉（SCV）狭窄的发生有关。在1例病例中，永久性通路的使用因严重的手臂水肿而受到严重限制。我们得出结论，除了SCV插管常见的并发症外，长期使用SCV血液透析导管可能会导致严重的晚期阻塞性并发症，这可能会损害永久性血管通路。我们建议，在进行血液透析的患者中，只要有可能，临时透析导管和其他锁骨下导管应放置在与永久性血管通路部位对侧。
