[Central venous stenosis: review of the literature from 1980 to 2000].
Publications of central veins stenoses were still frequently related though improvements of the catheter quality and the catheterism procedures since the 1980's. The review of the literature during the period of 1980-2000 helped us in observations as following: Global incidence was 15.6% in subclavian vein stenoses (SVSC), 2.7% in jugular stenoses (SVJ) and 0-3.8% in femoral stenoses (SVF). The "non-symptomatic" SVSC, detected by Venograms, represented only 23-33% of all SVSC publications but they showed higher incidence in the patients than "symptomatic" SVSC: 41% versus 3.3% just as for non-symptomatic SVJ: 9% versus 1.6% in symptomatic SVJ. Venograms with "in-arm-injections" mostly used by authors should underevaluated the incidence of SVJ. Mecanisms were betterly detailed with SVSC than SVJ and SVF (Catheter quality, venous lesions by portions and artérialisation by fistulas, anatomic constraints of the subclavian vein in the triangle space behind the clavicular, fibrin sleeve, thrombus and microtraumatism of the Veins walls...). Global results of the treatment, though improvement with angioplasty-Stent, remained disappointing by early recurrences. Worsened dialysis adequacy and life quality of the patients should be the issues. The number of the catheters currently used in temporary accesses, including the subclavian veins, and in permanent accesses was still higher than DOQI/NKF recommendations. Anticipated creations of Fistulas should be one efficient prevention.
Huu
T C
TC
Service de néphrologie, Hôpitaux Brabois, CHU Nancy. t.cao-huu@chu-nancy.fr
D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000453:epidemiology; D005268:Femoral Vein; D006801:Humans; D007601:Jugular Veins; D013350:Subclavian Vein; D014652:Vascular Diseases / Q000175:diagnosis / Q000453:epidemiology*