Central Vein Stenosis

Causes

The most common cause of CVS is the placement of catheters, such as central venous catheters (CVCs) or peripherally inserted central catheters (PICCs), in the jugular or subclavian veins. These catheters can irritate and damage the vein wall, leading to scar tissue formation and narrowing over time.

Other risk factors for CVS include:

• Indwelling pacemaker or defibrillator wires
• Previous infections
• Radiation therapy to the chest
• Certain inherited conditions affecting connective tissue

Symptoms

CVS may not cause any symptoms in its early stages. However, as the narrowing worsens, symptoms can develop, including:

• Swelling of the arm, face, neck, or chest on the affected side
• Discomfort or pain in the affected area
• Difficulty breathing
• Dizziness
• Headaches
• Recirculation during hemodialysis (for dialysis patients)

Diagnosis

Diagnosing CVS typically involves a combination of tests, including:

• Medical history and physical examination: Your doctor will ask about your symptoms, medical history, and any recent procedures that may have increased your risk of CVS.
• Venography: A contrast dye is injected into a vein, and X-rays are taken to visualize the veins and identify any blockages.
• Ultrasound: This painless imaging test uses sound waves to create images of the veins and assess blood flow.
• Computed tomography (CT) scan or magnetic resonance imaging (MRI) scan: These imaging tests can provide detailed views of the veins and surrounding tissues.

Treatment

Treatment for CVS depends on the severity of the narrowing and your symptoms. Options may include:

• Medication: Blood thinners can help prevent blood clots from forming in the narrowed vein.
• Angioplasty: A thin tube with a balloon at its tip is inserted into the narrowed vein. The balloon is inflated to widen the vein. A stent, a small expandable tube, may be placed to keep the vein open (Click here to read more on Angioplasty/ stenting)
• Bypass surgery: In severe cases, surgery may be necessary to create a new passage for blood to flow around the blockage.

Prognosis

The long-term outlook for people with CVS depends on the severity of the condition and the underlying cause. Early diagnosis and treatment can improve the prognosis. However, CVS can recur, and long-term follow-up is necessary.