Surgical Correction of Innominate and Brachiocephalic Vein Occlusion from Radiation Therapy and Multiple Indwelling Portacatheters A Case Report

Abstract

Radiation-induced arteriopathy is more commonly encountered than venopathy. Total upper extremity venous tributaries' occlusion to the superior vena cava is extremely uncommon. This communication describes a simplified surgical management to enhance upper extremity venous return to the superior vena cava to resolve the incapacitating arm swelling and introduces the concept of a direct arteriovenous graft to a nonexpansive polytetrafluoroethylene (PTFE) graft to create a nonprogressive fistula requiring no future ligation and providing the Venturi effect. The direct arteriovenous fistula in central venous bypass has been proven efficacious and durable in previous studies.