الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
carefully. Multiple diaylsis catheter insertion is a significant risk factor for the development of CVS . Idiopathic unprovoked CVS can happen, however it is less common. Clinical examination may be enough to suspect CVS and then investigations using different tools should be done.
Preoperative duplex and intraoperative venography were done to all patients included in this study seeking VA creation to rule out CVS. Among these 50 patients, 12 patients had CVS by preoperative duplex, but 16 patients had CVS by intraoperative venography and AV access operation was avoided and aborted , and then they were planned for elective management. On the other side , 34 patients had no CVS by both duplex confirmed by venography and AV access was created successfully reducing the risk development of venous hypertension .
Early referral of patients with chronic kidney disease for early discussion of kidney replacement modalities , including non-hemodialysis options ( like peritoneal dialysis and renal transplantation) and creation of arteriovenous access prior to the start of hemodialysis and avoidance of catheter insertion and other central vein cannulation will avoid the development of CVS in most of the patients with renal diseases.
Basically, Central venous catheterization is the most important predisposing risk factor for development of CVS. As matched in our results where 10 patients without history of CDC insertion had no CVS clinically and confirmed by duplex and venography , while in 40 patients with history of CDC insertion, 12 patients out of them had CVS by duplex and 16 patients had CVS by venography that ensured the significance of venography in CVS detection over the preope