{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:43:30Z","timestamp":1776991410943,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,4,3]],"date-time":"2013-04-03T00:00:00Z","timestamp":1364947200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Tunneled hemodialysis catheters are well\u2010documented causes of benign central vein stenosis, which can be associated with proximal or downhill esophageal varices due to shunting of blood flow from the upper portion of the body through the esophageal venous plexuses. A majority of these cases remain asymptomatic. As a result, studies are largely limited to symptomatic patients, with incidence rates ranging from 16% to 29%. Recently, Hemodialysis Reliable Outflow (HeRO) graft has been introduced as an effective alternate hemodialysis access in catheter\u2010dependent patients, especially in the presence of significant central venous occlusion. It differs from a conventional arteriovenous graft (AVG) by the fact that its venous outflow end is in the right atrium via one of the central veins, bypassing any significant occlusion upstream. Lower intervention rates and reduced incidence of bacteremia make it comparable to conventional tunneled catheters. However, the incidence of central vein occlusion and associated complications with HeRO grafts is unknown. We present the first case of gastrointestinal bleeding from downhill esophageal varices secondary to HeRO \u2013 graft\u2010related SVC occlusion.<\/jats:p>","DOI":"10.1111\/sdi.12078","type":"journal-article","created":{"date-parts":[[2013,4,3]],"date-time":"2013-04-03T07:51:16Z","timestamp":1364975476000},"source":"Crossref","is-referenced-by-count":9,"title":["Downhill Varices Secondary to HeRO Graft\u2010Related SVC Syndrome"],"prefix":"10.1111","volume":"26","author":[{"given":"Unnikrishnan","family":"Pillai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kahlon","family":"Roopkiranjot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nandagopal","family":"Lakshminarayan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishna","family":"Balabhadrapatruni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wihib","family":"Gebregeorgis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Kissner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,4,3]]},"reference":[{"key":"e_1_2_4_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfn261"},{"key":"e_1_2_4_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-139X.2007.00242.x"},{"issue":"10","key":"e_1_2_4_4_2","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1177\/000313480206801016","article-title":"Dialysis access\u2010induced superior vena cava syndrome","volume":"68","author":"Madan AK","year":"2002","journal-title":"Am Surg"},{"key":"e_1_2_4_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000198474.99876.f0"},{"key":"e_1_2_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(12)80746-3"},{"issue":"8","key":"e_1_2_4_7_2","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1681\/ASN.V981507","article-title":"Subclavian vascular access stenosis in dialysis patients: natural history and risk factors","volume":"9","author":"Hernandez D","year":"1998","journal-title":"J Am Soc Nephrol"},{"key":"e_1_2_4_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-008-0055-4"},{"key":"e_1_2_4_9_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.46.6.740"},{"issue":"11","key":"e_1_2_4_10_2","first-page":"903","article-title":"[Upper esophageal varices. 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