Subclavian vein stenosis
Subclavian vein stenosis refers to a narrowing of the subclavian vein.
Presentation can be variable ranging from being asymptomatic to having arm swelling, arm pain, paresthaesia, neck pain and occipital headaches.
Subclavian vein stenosis can arise from number of intrinsic as well as extrinsic causes and can be complicated by subclavian vein DVT.
- extrinsic compression of the left brachiocephalic vein between the sternum and arch vessels (part of thoracic outlet syndrome)
- Paget-Schrötter syndrome
- regional tumours, e.g. lymphadenopathy
- mediastinal inflammatory pseudotumour 1
- stenosis associated with previous intravenous lines such as haemodialysis catheters 2
- haemodialysis-related subclavian vein stenosis, thought to be from intimal hyperplasia secondary to increased turbulent flow from a created arteriovenous fistula 5
Treatment and prognosis
Interventional radiological treatment options include percutaneous balloon angioplasty, intravascular stent placement, and transcatheter thrombolysis.
- 1. Kim H, Chung JW, Park JH et-al. Role of CT venography in the diagnosis and treatment of benign thoracic central venous obstruction. Korean J Radiol. 2003;4 (3): 146-52. doi:10.3348/kjr.2003.4.3.146 - Free text at pubmed - Pubmed citation
- 2. Levit RD, Cohen RM, Kwak A et-al. Asymptomatic central venous stenosis in hemodialysis patients. Radiology. 2006;238 (3): 1051-6. doi:10.1148/radiol.2383050119 - Pubmed citation
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- 4. Kim H, Chung JW, Park JH et-al. Role of CT venography in the diagnosis and treatment of benign thoracic central venous obstruction. Korean J Radiol. 2003;4 (3): 146-52. doi:10.3348/kjr.2003.4.3.146 - Free text at pubmed - Pubmed citation
- 5. Kundu S. Central venous obstruction management. Semin Intervent Radiol. 2009;26 (02): 115-21. doi:10.1055/s-0029-1222454 - Free text at pubmed - Pubmed citation