Chronic Venous Insufficiency of the Upper Limb Due to Outflow Obstruction of Venous Access

Abstract

Two patients with angio-access for haemodialysis in whom the main venous outflow tract was thrombosed, developed severe chronic venous insufficiency (CVI) of the upper limb after a short period; one case developing a stasis ulcer of the cubital fossa. The angio-accesses were still functioning when the diagnosis was made. Treatment by surgery resulted in a dramatic regression of clinical signs of chronic venous insufficiency. CVI of the upper limb has not previously been described.

CVI is a frequent and known complication after deep vein thrombosis (DVT) of the lower limbs, but never appears after DVT of the upper limbs. We describe two cases of upper limb CVI which developed as a complication of angio-access for haemodialysis treatment, and their successful treatment by surgery.