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Catheterization via direct cannulation of superior vena cava for a hemodialysis patient with an original dysfunctional catheter on the left internal jugular vein |
Li Zhou1, Lin Chen1, Yang Yu1,2, Tianlei Cui1,2(), Xiao Li2, Ping Fu1 |
1. Division of Nephrology, Department of Internal Medicine, West China Hospital, Sichuan University, Chengdu 610041, China 2. Department of Intervention Medicine, West China Hospital, Sichuan University, Chengdu 610041, China |
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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.
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Keywords
superior vena cava
intervention
vascular access exhaustion
catheterization
tunneled cuffed hemodialysis catheter
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Corresponding Author(s):
Tianlei Cui
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Just Accepted Date: 14 April 2017
Online First Date: 07 June 2017
Issue Date: 29 August 2017
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