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Citation:
Iqbal S, Knipe H, Brachiocephalic vein stenosis. Reference article, Radiopaedia.org (Accessed on 24 Apr 2024) https://radiopaedia.org/articles/77170
Brachiocephalic vein stenosis refers to a narrowing of the brachiocephalic vein. It is commonly seen in chronic hemodialysis patients.
A study conducted in Chinese population shows a prevalence of stenosis in hemodialysis patients was 30-50% 3.
The presentation can be variable ranging from facial swelling, retrograde blood flow in to the jugular vessels and cerebral venous hypertension 2.
Brachiocephalic vein stenosis can originate from multiple causes:
- left brachiocephalic vein compression between the sternum and aortic arch vessels
- prior IV lines, e.g. dialysis catheters
Complications
- brachiocephalic thrombus formation
Treatment and prognosis
Brachiocephalic vein re-narrowing is common following stent placement. Balloon angioplasty or surgical intervention, to conserve an arm for haemodialysis, is also an option
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1. Shi Y, Shi YM, Shi LW, Shi ZH, Shi ZY, Shi ZJ, Shi. Endovascular Treatment of Central Venous Stenosis and Obstruction in Hemodialysis Patients. (2013) Chinese medical journal. doi: - Pubmed
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2. Eames P, Senthil L, Thomas A, Riley P, Burdon MA. Brachiocephalic vein stenosis in association with ipsilateral hyperdynamic brachio-basilic fistula causing ipsilateral facial swelling and contralateral papillodema and visual loss. A case report. (2010) Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. 16 (3): 322-5. doi:10.1177/159101991001600316 - Pubmed
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3. Li H, Wang SX, Wang W, Xu C, Shen S, Yu L, Zhang GZ. Thrombosis of the superior vena cava and auxiliary branches in patients with indwelling catheterization of the internal jugular vein. (2009) Chinese medical journal. 122 (6): 692-6. Pubmed
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4. Aj A, Razak Uk A, R P, Pai U, M S. Percutaneous intervention for symptomatic central vein stenosis in patients with upper limb arteriovenous dialysis access. (2018) Indian heart journal. 70 (5): 690-698. doi:10.1016/j.ihj.2018.01.013 - Pubmed
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