title: Lower extremity arteriovenous fistula with central venous stenosis iliocaval stenting to treat venous outflow obstruction.
abstract: Maintenance of hemodialysis access for end-stage renal disease continues to be a major challenge for vascular surgeons, nephrologists, and primary care physicians. This case report highlights the complication and treatment of lower extremity central venous stenosis, allowing continued dialysis access for a patient with limited remaining fistula options. This stenosis resulted from the prolonged use of a lower extremity central venous catheter. This case highlights the importance of imaging the central veins in obstruction of lower extremity fistulas. Once detected, as in the upper extremity, this can be effectively treated using balloon dilation and stenting.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, NY 14642, USA.
authors.forename: Neil G
authors.initials: NG
authors.lastname: Kumar
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Dugan
authors.forename: Karl A
authors.initials: KA
authors.lastname: Illig
authors.forename: David L
authors.initials: DL
authors.lastname: Gillespie
mesh_terms: D017130:Angioplasty / Q000295:instrumentation*; D001166:Arteriovenous Shunt, Surgical; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002496:Central Venous Pressure; D003097:Collateral Circulation; D003251:Constriction, Pathologic; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D012039:Regional Blood Flow; D006435:Renal Dialysis; D015607:Stents; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000503:physiopathology; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*