Approche des oedèmes du membre supérieur liés à une occlusion de la veine sous-clavière située en aval d'une fistule artério-veineuse [Approach to upper limb edema secondary to subclavian vein occlusion situated distal to an arteriovenous fistula]

Détails

ID Serval
serval:BIB_10B2E9E260B7
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
Approche des oedèmes du membre supérieur liés à une occlusion de la veine sous-clavière située en aval d'une fistule artério-veineuse [Approach to upper limb edema secondary to subclavian vein occlusion situated distal to an arteriovenous fistula]
Périodique
Annales de chirurgie
Auteur(s)
Prêtre R., Delay D., Bonada I., Murith N.
ISSN
0003-3944
Statut éditorial
Publié
Date de publication
1998
Peer-reviewed
Oui
Volume
52
Numéro
4
Pages
331-7
Langue
français
Notes
Publication types: Case Reports ; English Abstract ; Journal Article ; Review - Publication Status: ppublish
Résumé
AIM OF THE STUDY: To analyse the course of upper limb edema in patients with an arteriovenous fistula used for dialysis and to analyse the available therapeutic options. STUDY DESIGN: Retrospective study of patients with this type of edema, who were treated in our institution from 1992 to 1996. PATIENTS AND METHODS: Seven consecutive patients with an arterioveinous fistula treated for edema of the upper extremity, were reviewed. The fistula was created at the elbow in 6 patients and at the forearm in 1. The edema appeared immediately after operation in 4 patients and after a delay in 3 patients. Stenosis (3 patients) or occlusion (2 patients) of the subclavian vein was documented in 5 patients who were investigated by angiography. RESULTS: The edema regressed spontaneously in 4 patients because collaterals developed in 3 patients, and the fistula thrombosed in 1 patient. Surgical intervention allowed regression of the edema in the other 3 patients: excessive output of the fistula was reduced in 2 patients and an axillojugular bypass was performed in 1 patient. The fistula remained effective in 6 patients. Another fistula was performed on the contralateral arm in 1 patient. CONCLUSION: Non-operative management is recommended in patients who develop edema immediately after creation of the fistula, because spontaneous regression is likely. Measures aimed at reducing the output of the fistula or enhancing the venous capacities of the arm are required when edema appears at a later stage. The fistula can be saved in the majority of cases.
Mots-clé
Aged, Arm, Arteriovenous Shunt, Surgical, Collateral Circulation, Constriction, Pathologic, Edema, Female, Humans, Male, Remission, Spontaneous, Renal Dialysis, Subclavian Vein, Survival Analysis
Pubmed
Web of science
Création de la notice
28/01/2008 10:14
Dernière modification de la notice
20/08/2019 13:37
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