Heart Views

: 2016  |  Volume : 17  |  Issue : 4  |  Page : 164--165

Superior vena cava syndrome-like phenomenon on vascular access

Akihito Tanaka1, Yuichi Ito2,  
1 Department of Nephrology, Nakatsugawa City Hospital, Nakatsugawa City, Gifu Prefecture, Japan
2 Department of Emergency Medicine, Nagoya Ekisaikai Hospital, Nagoya, Japan

Correspondence Address:
Dr. Akihito Tanaka
Department of Nephrology, Nakatsugawa City Hospital, 1522-1 Komaba, Nakatsugawa City, Gifu Prefecture - 508-8502

How to cite this article:
Tanaka A, Ito Y. Superior vena cava syndrome-like phenomenon on vascular access.Heart Views 2016;17:164-165

How to cite this URL:
Tanaka A, Ito Y. Superior vena cava syndrome-like phenomenon on vascular access. Heart Views [serial online] 2016 [cited 2023 May 30 ];17:164-165
Available from: https://www.heartviews.org/text.asp?2016/17/4/164/201777

Full Text

A septuagenarian man who had chronic renal failure was admitted to our hospital for vascular access formation.

He had a past history of thoracic and abdominal aortic aneurysm [Figure 1]. An arteriovenous fistula was made on his left forearm. After operation, the swelling of his forearm did not improve. A month later, he was initiated into hemodialysis therapy. After initiation, we performed vascular access angiography with suspicion of venous stenosis. [Figure 2a] is an angiography of his left subclavian vein during the phase of expiration which shows regurgitation into the cervical vein. The regurgitation occurred along with the edge of aortic aneurysm. [Figure 2b] is also an angiography during the phase of inspiration which did not show regurgitation. Aortic aneurysm sometimes causes superior vena cava (SVC) syndrome by compression of surrounding veins.[1],[2] We considered a similar phenomenon occurred partially during only the phase of expiration. The cause of only partial compression which resulted in forearm swelling was considered to be the increase of blood flow with vascular access.{Figure 1}{Figure 2a}{Figure 2b}

We should take this phenomenon, not only venous stenosis, into consideration when we see swollen forearm with vascular access.


1Dayan V1, Michelis V, Lorenzo A. Giant aortic aneurysm as a rare cause of superior vena cava syndrome. Ann Thorac Surg 2008; 86:1383.
2Vydt T1, Coddens J, Wellens F. Superior vena cava syndrome caused by a pseudoaneurysm of the ascending aorta. Heart 2005; 91: e29.