Subclavian vein single-needle dialysis in acute renal failure following vascular surgery

Acute renal failure, following major surgery of the abdominal aorta, was managed in 3 patients using the subclavian vein for single-needle dialysis. Peritoneal dialysis could not be done, as the posterior peritoneum is violated. Blood access for hemodialysis also poses several problems. Percutaneous cannulization of the femoral vein is risky because of the possibility of accidental entry into the synthetic graft. The subclavian vein provides an alternate source of blood supply for single-needle dialysis in these high-risk postsurgical patients who have acute renal failure. Several advantages are described with this technique, including preservation of forearm vessels. Utmost care has to be taken during cannulization of the subclavian vein, as well as meticulous attention given, to prevent infection.