Pseudostenosis of axillary vein due to adduction of the upper limb

Axillary vein stenosis is a well-documented complication in hemodialysis (HD) patients, but in adipose or athletic subjects, pseudostenosis of the axillary vein can be detected. We report a case of pseudostenosis in a fit dialysis patient who underwent phlebography of the right upper limb, performed to create a new vascular access (VA). The investigation demonstrated that the axillary vein appeared sharpened with a reduced lumen. Based on this exam, angioplasty of the right axillary vein was planned. The new phlebographic study, performed abducting the arm, demonstrated that the previously marked stenosis of the axillary vein disappeared. Our case illustrates how the reduction of the axillary vein lumen was secondary to "muscular print" and was present only if the arm was adducted. In uremic patients, the squeezing of the vascular nervous bundle of the upper limb is possible in fit patients at the time of phlebography, an examination that should be performed with the arm both in adduction and abduction.