Venous Hypertension Associated with Arteriovenous Hemodialysis Access

Richard F. Neville, Christopher J. Abularrage, Paul W. White, Anton N. Sidawy

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Venous hypertension is a significant problem for the patient on chronic hemodialysis. This condition can result in impairment of arteriovenous access function, disabling upper extremity edema with bluish discoloration and pigmentation of the skin, and, in advanced cases, ulceration of the finger tips and neuralgias. Venous hypertension usually results from central vein stenosis or valvular incompetence in the arteriovenous access outflow vein. A high index of suspicion is required to identify patients at risk for venous hypertension. A history of ipsilateral central venous catheter placement, or physical signs such as visible distended shoulder venous collaterals, and upper extremity edema are suggestive. Diagnosis is confirmed with Duplex ultrasound or contrast venography. The primary goal of diagnosis and therapy of venous hypertension is symptomatic relief while maintaining the functionality of the access. Treatment includes percutaneous catheter-based and open surgical techniques. Open surgical techniques, while more invasive, remain the gold standard as long-term patency after angioplasty, with or without covered stents, remains unproven.

Original languageEnglish (US)
Pages (from-to)50-56
Number of pages7
JournalSeminars in vascular surgery
Issue number1
StatePublished - Mar 2004
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Venous Hypertension Associated with Arteriovenous Hemodialysis Access'. Together they form a unique fingerprint.

Cite this