Long thoracic vein embolization for the treatment of breast edema associated with central venous occlusion and venous hypertension.
OBJECTIVE
Breast edema is a rare complication in hemodialysis patients with central venous occlusions. The present study sought to determine whether coil embolization of the long thoracic vein is an effective long-term treatment for this pathology.


METHODS
The study patients were 6 female hemodialysis patients whose primary clinical manifestation of central vein occlusion was breast edema. When conservative treatment (allowing collaterals to dilate over time), as well as recanalization of occlusions through angioplasty with or without stent placement, failed to alleviate symptoms, patients underwent coil embolization of the long (lateral) thoracic vein.


RESULTS
In 4 of the 6 cases, the breast edema was completely resolved without recurrence, while the other 2 patients experienced durable symptomatic improvement with only mild residual swelling. Average follow-up was 22 months. There were no adverse sequelae and none of the patients experienced increased swelling elsewhere following the coil embolization procedure.


CONCLUSIONS
Coil embolization of the long thoracic vein effectively alleviates breast edema in hemodialysis patients with elevated venous hydrostatic pressure due to central venous occlusions.
Miller
Gregg Arthur
GA
American Access Care of Brooklyn, Brooklyn, NY, USA. vascular1@att.net
Friedman
Alexander
A
Khariton
Aleksandr
A
Jotwani
Manish C
MC
Savransky
Yevgeny
Y
D000328:Adult; D000368:Aged; D001941:Breast Diseases / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003251:Constriction, Pathologic; D004487:Edema / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008875:Middle Aged; D010690:Phlebography; D006435:Renal Dialysis; D013997:Time Factors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014654:Vascular Patency; D014680:Veins / Q000503:physiopathology; D014690:Venous Pressure