Background: Venous hypertension of the hand is an unusual complication of an arteriovenous shunt in patients receiving dialysis.
Objective: We investigated whether in venous hypertension of the hand pericapillary cuffs are present and whether they consist of fibrin and other components.
Methods: Biopsy specimens were taken from three patients with a side-to-side shunt and venous hypertension of the hand, from three patients with an end-to-side shunt without venous hypertension, and from three control subjects. The specimens were stained with antibodies against fibrinogen, fibrin, plasminogen activator inhibitor-I, factor VIII-related antigen, and collagen type IV.
Results: Pericapillary cuffs consisting of fibrin only were observed in patients with venous hypertension of the hand. In this fibrin network, factor VIII-related antigen and collagen type IV were also present. The finding of plasminogen activator inhibitor-I in the pericapillary cuff in the patient with the most severe signs of venous hypertension may indicate that breakdown of this fibrin cuff is impaired.
Conclusion: Pericapillary cuffs may be of pathogenetic significance in venous hypertension of the hand.