Catheterization via direct cannulation of superior vena cava for a hemodialysis patient with an original dysfunctional catheter on the left internal jugular vein

Abstract

Establishing a long-term vascular access in patients exhibiting vascular access exhaustion is challenging. In this study, we reported a case of a direct catheterization in the superior vena cava of a hemodialysis patient with vascular access exhaustion and original dysfunctional catheter inserted via the left internal jugular vein. The direct catheterization was performed with cuffed tunnel catheter (CUFF) and guided by digital subtraction angiography (DSA) and multidetector computed tomography venography (MDCTV). The DSA and MDCTV results revealed an occlusion in the right innominate vein and thromboses in the left innominate, right internal jugular, subclavian, and femoral veins. The distal end of the superior vena cava was localized clearly by the original CUFF under DSA. Directed at the distal end of the superior vena cava, a 0.5-cm secondary puncture was introduced below the lateral head of the sternocleidomastoid muscle via the right neck area. This study is one of the few reports regarding direct catheterization of CUFF via the superior vena cava of a patient with vascular access exhaustion and CUFF dysfunction on the left internal jugular vein. We believe that our study can provide a new alternative for inserting central venous catheter for such patient.

Keywords

superior vena cava / intervention / vascular access exhaustion / catheterization / tunneled cuffed hemodialysis catheter

References

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Acknowledgments

This work was supported by grants from The National Key Technology R&D Program of China (No. 2011BAI10B08).

Compliance with ethics guidelines

Li Zhou, Lin Chen, Yang Yu, Tianlei Cui, Xiao Li, and Ping Fu declare that they have no conflict of interest. The new technique study of catheterization via direct cannulation of superior vena cava for hemodialysis by intervention, has been approved by clinical trials and biomedical ethics committee of West China Hospital, Sichuan University.

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