A rare case of an aortic arch stent causing central vein stenosis

Abstract

Central vein stenosis is commonly encountered in end stage renal disease patients on hemodialysis. Most are manageable with repeated procedures and venoplasty, however in some cases, venoplasty may not be successful. We discuss a rare case of persistent upper limb swelling due to severe central vein stenosis from compression of an aortic arch stent. Despite attempt at prolonged balloon inflation during venoplasty of the central vein, the stenosis still persisted. The arteriovenous fistula was then ligated and other forms of vascular access for hemodialysis were sought after. Central venograms may be useful in end stage renal failure patients as part of pre-operative arteriovenous fistula creation so as to anticipate the possibility of central vein stenosis and its associated complications.