Subclavian Venous Stenosis

Subclavian hemodialysis catheters are widely employed for temporary hemodialysis access, but there are few reports of serious complications. We report three cases in which the prolonged (>15 days) use of subclavian dialysis catheters ipsilateral to the permanent vascular access was associated with the development of subclavian vein (SCV) stenosis three to six months after the temporary catheter was removed. In one case, the use of the permanent access was severely limited by massive arm edema. We conclude that, in addition to the usual complications of SCV cannulation, long-term use of SCV hemodialysis catheters can be associated with major late obstructive complications that may compromise permanent vascular access. We recommend that, wherever possible, temporary dialysis catheters and other subclavian lines be placed contralateral to the permanent vascular access site in patients undergoing hemodialysis. (JAMA1984;252:3404-3406)