Ulcers of the fingers and dorsum of the left hand caused by venous hypertension after construction of a brachiocephalic arteriovenous fistula: case report.

Venous ulcers caused by venous hypertension secondary to arteriovenous fistulae are rare. Their etiology can be confirmed by vascular Doppler ultrasonography, which can differentiate between stenosis of central vessels and hemodynamic overload caused by development of tributaries from the vein responsible for the arteriovenous fistula. We present a case caused by hemodynamic overload of a tributary, which diverted the primary flow from the fistula to the distal limb.

Anatomic variant of the internal jugular vein and its importance in vascular access for hemodialysis.

The right internal jugular vein is considered the best route for vascular access, because of low complication rates and satisfactory flow during hemodialysis, due to its straight route to the right atrium. This paper reports the identification, prior to puncture, of an anatomic variant position of the internal jugular vein in relation to the common carotid artery. The benefit of this prior identification is highlighted, emphasizing the importance of performing vascular Doppler ultrasound rather than using only external anatomical observation for puncture of the internal jugular vein.