Abstract
Scientific advances over the past 30 years or so have also created new problems including those created when devices of several sorts are implanted into the subclavian and less often into the jugular veins [1, 2]. These include insertion of pacemaker leads to treat cardiac arrhythmias, defibrillator leads to treat and prevent sudden death due to ventricular fibrillation, catheters for dialysis [3] when IV fistulas either cannot be used or are being constructed, central venous catheters used for prolonged infusion of antibiotics or chemotherapeutic agents, and central intravenous alimentation lines. Whenever a catheter simply touches venous endothelium fibrotic reaction can occur and in the worst-case scenario may lead to total obliteration of the superior vena cava. These are obviously very complicated and difficult problems to treat, especially when total obstruction of the veins occurs. They may become overwhelming when venous sites of the opposite side are utilized transferring the problem to other veins which will be affected in the same manner.
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Scientific advances over the past 30 years or so have also caused new problems including those caused when devices of several sorts are implanted into the subclavian and less often into the jugular veins [1, 2]. These include insertion of pacemaker leads to treat cardiac arrhythmias, defibrillator leads to treat and prevent sudden death due to ventricular fibrillation, catheters for dialysis [3] when IV fistulas either cannot be used or are being constructed, central venous catheters used for prolonged infusion of antibiotics or chemotherapeutic agents, and central intravenous alimentation lines. Whenever a catheter simply touches venous endothelium fibrotic reaction can occur and in the worst-case scenario may lead to total obliteration of the superior vena cava. These are obviously very complicated and difficult problems to treat, especially when total obstruction of the veins occurs. They may become overwhelming when venous sites of the opposite side are utilized transferring the problem to other veins which will be affected in the same manner.
References
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Kock HJ, Dietsch M, Kravse U, Wilke H, Eigler FW. Implantable vascular access system: Âexperience in 1500 patients with totally implanted central venous port systems. World J Surg. 1998;22:12–6.
Seelig MH, Oldenburg WA, Klinger PJ, Odell JA. Superior vena cava syndrome caused by chronic hemodialysis catheters: autologous reconstruction with a pericardial tube graft. J Vasc Surg. 1998;28:556–60.
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Molina, J.E. (2013). Venous Obstructions Due to Implanted Devices. In: New Techniques for Thoracic Outlet Syndromes. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5471-7_14
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DOI: https://doi.org/10.1007/978-1-4614-5471-7_14
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