Authors
Yusaku Watanabe, Kiyonori Ito, Yuko Mutsuyoshi, Shun Ishibashi, Junki Morino, Haruhisa Miyazawa, Yoshio Kaku, Susumu Ookawara
Published in
The journal of vascular access. Pages 11297298261463598. Jul 06, 2026. Epub Jul 06, 2026.
Abstract
Central vein stenosis or occlusion is a significant cause of vascular access dysfunction in patients with chronic kidney disease (CKD). Typically related to intraluminal factors such as long-term cuffed hemodialysis catheters or thrombus formation, central venous stenosis may also result from extrinsic compression by adjacent musculoskeletal or vascular structures. Here we report a case of central vein stenosis secondary to extrinsic compression caused by pericardial effusion. A 68-year-old woman with CKD secondary to immunoglobulin A nephropathy underwent left forearm arteriovenous fistula (AVF) creation before dialysis initiation and developed severe edema of the left upper limb. Computed tomography revealed stenosis of the left brachiocephalic vein for which percutaneous transluminal angioplasty was performed; recanalization was achieved. However, the thrombus in the brachiocephalic vein persisted; therefore, anticoagulation therapy and a pericardiocentesis were performed, resulting in the draining of more than 2 L of fluid. Thereafter, the thrombus disappeared, stenotic lesion improved, and upper-limb edema improved. Throughout this case, clinicians should be aware of this potential complication caused by a massive pericardial effusion, and additionally, prompt combination therapy, that is, endovascular therapy, anticoagulation therapy, or pericardiocentesis, could maintain a patent AVF.
PMID:
42410979
Bibliographic data and abstract were imported from PubMed on 07 Jul 2026.
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