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The majority of patients with end-stage renal disease are dependent on hemodialysis. Significant stenosis or occlusion of the subclavian vein is known to occur in 20% to 50% of patients who have had central venous catheters inserted into the subclavian vein or the internal jugular vein. Surgical bypass of the obstructed venous segment proximal to a functioning dialysis access site is an established treatment to relieve symptoms and salvage the functional dialysis access.

A retrospective review of all subclavian venous bypass procedures performed at St Louis University Hospital from May 1987 to May 2000 was undertaken. Twelve procedures were performed during this time. The mean age of the patient was 55.5 years (range 17 to 72 years). There were 11 men and 1 woman. Before surgical bypass, all patients underwent bilateral venograms to evaluate their central venous …