[Surgery of vascular access for hemodialysis and central venous stenosis]

Central venous stenosis is a complication of central vein catheter insertion through the internal jugular or the femoral vein in haemodialysed patients with non-functioning arteriovenous angio-access. The frequent complication is important limb swelling after subsequent creation of upstream arteriovenous fistula or graft. Closure of the fistula may be necessary, especially if creation of a new access is possible on the opposite limb. Surgical conservative treatment may be indicated. Percutaneous transluminal angioplasty is used first with good short-term results. Prevention of central venous stenosis by infrequent use of central venous catheter is of the utmost importance.