PLEURAL EFFUSION ASSOCIATED WITH IPSILATERAL BREAST AND ARM EDEMA AS A COMPLICATION OF SUBCLAVIAN VEIN CATHETERIZATION AND ARTERIOVENOUS-FISTULA FORMATION FOR HEMODIALYSIS

A 38-year-old woman with end-stage kidney disease presented with a ple ural effusion and profound edema of the ipsilateral arm and breast. A patent hemodialysis arteriovenous fistula access was present in the in volved extremity. Brachiocephalic vein stenosis, as a result of previo us dialysis catheter placement in the subclavian vein, was demonstrate d by ultrasound imaging and Doppler analysis. Takedown of the arteriov enous fistula in the edematous arm along with living-related kidney tr ansplantation caused immediate resolution of the breast and arm edema and rapid clearing of the effusion. An anatomic explanation for the fi ndings is offered.