Subclavian vein stenosis refers to a narrowing of the subclavian vein.
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Clinical presentation
Presentation can be variable ranging from being asymptomatic to having arm swelling, arm pain, paresthesia, neck pain and occipital headaches.
Pathology
Subclavian vein stenosis can arise from a number of intrinsic as well as extrinsic causes and can be complicated by subclavian vein DVT.
Etiology
Extrinsic
- extrinsic compression of the left brachiocephalic vein between the sternum and arch vessels (part of thoracic outlet syndrome)
- Paget-Schrötter syndrome
- regional tumors, e.g. lymphadenopathy
- mediastinal inflammatory pseudotumor 1
Intrinsic
- 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.