scholarly journals Central Venous Stenosis after Hemodialysis: Case Reports and Relationships to Catheters and Cardiac Implantable Devices

2019 ◽  
Vol 9 (3) ◽  
pp. 135-144 ◽  
Author(s):  
Mario Pacilio ◽  
Silvio Borrelli ◽  
Giuseppe Conte ◽  
Roberto Minutolo ◽  
Antonino Musumeci ◽  
...  
Keyword(s):  
Case Reports ◽  
Superior Vena ◽  
Sinus Node ◽  
Vena Cava ◽  
Venous Catheter ◽  
Transluminal Angioplasty ◽  
Central Venous ◽  
Central Venous Stenosis ◽  
Cardiac Devices ◽  
Venous Stenosis

The appropriate vascular access for hemodialysis in patients with cardiac implantable electronic devices (CIED) is undefined. We describe two cases of end-stage renal disease patients with CIED and tunneled central venous catheter (CVC) who developed venous cava stenosis: (1) a 70-year-old man with sinus node disease and pacemaker in 2013, CVC, and a Brescia-Cimino forearm fistula in 2015; (2) a 75-year-old woman with previous ventricular arrhythmia with implanted defibrillator in 2014 and CVC in 2016. In either case, after about 1 year from CVC insertion, patients developed superior vena cava (SVC) syndrome due to stenosis diagnosed by axial computerized tomography. In case 1, the patient was not treated by angioplasty of SVC and removed CVC with partial resolving of symptoms. In case 2, a percutaneous transluminal angioplasty with placement of a new CVC was required. To analyze these reports in the context of available literature, we systematically reviewed studies that have analyzed the presence of central venous stenosis associated with the simultaneous presence of CIED and CVC. Five studies were found; two indicated an increased incidence of central venous stenosis, while three did not find any association. While more studies are definitely needed, we suggest that these patients may benefit from epicardial cardiac devices and the insertion of devices directly into the ventriculus. If the new devices are unavailable or contraindicated, peritoneal dialysis or intensive conservative treatment in older patients may be proposed as alternative options.

scholarly journals Endovascular retrieval of two migrated stents from pulmonary artery by means of balloon catheter

2021 ◽  
Vol 5 ◽  
pp. 21
Author(s):  
Saad Saeed Alqahtani ◽  
Ahmed Kandeel Elhadad ◽  
Rusha Abdulmohsen Sarhan ◽  
Saleh Mohamed Alwaleedi
Keyword(s):  
Pulmonary Artery ◽  
Superior Vena ◽  
Balloon Catheter ◽  
Vena Cava ◽  
Brachiocephalic Vein ◽  
Central Venous ◽  
Venous Stenting ◽  
Central Venous Stenosis ◽  
Venous Stenosis ◽  
The Right

Long-term central venous catheters can be associated with central venous stenosis in up to 50% of cases. Central venous stenosis can be managed with central venous stenting which was demonstrated to restore patency and improve suboptimal results after percutaneous transluminal angioplasty. Dislodgment of venous stents into the right side of the heart or the pulmonary artery during stent deployment is one of the most feared complications of this procedure. Percutaneous removal of these migrated stents is the preferred alternative for the more invasive operative intervention, which may be very hazardous in these patients. We report an unusual case of a 52-year-old man on hemodialysis who underwent endovascular stenting to treat a tight stenosis of the right brachiocephalic vein and superior vena cava and suffered from stent migration to the left pulmonary artery, requiring removal by interventional radiologist.

Endovascular Central Venous Stenosis Treatment Ended With Superior Vena Cava Perforation, Pericardial Tamponade, and Exitus

2012 ◽  
Vol 26 (5) ◽  
pp. 733.e9-733.e12 ◽  
Author(s):  
Andrea Siani ◽  
Giustino Marcucci ◽  
Federico Accrocca ◽  
Roberto Antonelli ◽  
Federica Mounayergi ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Pericardial Tamponade ◽  
Central Venous ◽  
Central Venous Stenosis ◽  
Venous Stenosis

Cerebral hyperperfusion and other consequences of hemodialysis central vein catheters

2017 ◽  
Vol 18 (1_suppl) ◽  
pp. S82-S83 ◽  
Author(s):  
Haimanot Wasse
Keyword(s):  
Case Reports ◽  
Venous Catheter ◽  
Venous Hypertension ◽  
Central Vein ◽  
Central Venous ◽  
Venous Circulation ◽  
Central Venous Stenosis ◽  
Cerebral Hyperperfusion ◽  
Venous Stenosis ◽  
Stage Renal Disease

While central venous stenosis is a common consequence of protracted central venous catheter use, intracardiac device transvenous leads, and central venous instrumentation, the majority of patients who develop symptomatic central venous stenosis present with characteristic venous hypertension. However, some patients may develop an abnormal intracranial venous circulation and present with neurologic symptoms. This paper will summarize findings from case reports that describe the neurologic sequelae that can develop as a result of central venous stenosis/occlusion in end-stage renal disease patients with a functional arteriovenous access.

Electrosurgical Removal of a Central Venous Catheter Inadvertently Sutured Into the Superior Vena Cava

2021 ◽  
Author(s):  
Sandeep Arunothayaraj ◽  
Kristoffer Tanseco ◽  
Anna-Lucia Koerling ◽  
Andrew Hill ◽  
Jonathon Hyde ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Catheter ◽  
Central Venous

Hemodialysis Reliable Outflow graft: A valid option in patients with central venous stenosis

2020 ◽  
Vol 21 (6) ◽  
pp. 1023-1028
Author(s):  
Ana Carolina Figueiredo ◽  
Filipe Mira ◽  
Luís Rodrigues ◽  
Emanuel Ferreira ◽  
Nuno Oliveira ◽  
...  
Keyword(s):  
Vascular Access ◽  
Venous Catheter ◽  
Iliac Vein ◽  
Lower Limbs ◽  
Implantation Technique ◽  
Central Venous ◽  
Vein Thrombosis ◽  
Central Venous Stenosis ◽  
Venous Stenosis ◽  
Outflow Graft

Introduction: Central venous stenosis can be the main obstacle to the creation of an autologous vascular access in the upper limbs. The Hemodialysis Reliable Outflow graft was developed to provide an upper limb vascular access option to such patients, avoiding alternative, less advantageous options, such as lower limb vascular accesses or central venous catheters. Its advantages include catheter avoidance and, in case of lower limbs accesses, reduction of the ischemic risk and iliac vein thrombosis, potentially compromising a future kidney transplant. Patients and methods: Revision of the clinical files of the four patients who were placed a Hemodialysis Reliable Outflow device in our Center, including demographic variables, implantation technique characteristics, surgical complications, episodes of infection and thrombosis of the access, and need to place a transitory central venous catheter to undergo hemodialysis treatment. Results: Four Hemodialysis Reliable Outflow grafts were placed, which resulted in a significant improvement in the dialysis efficacy in all patients, with a median raise in the Kt/V of 36.7%. Two cases needed thrombectomy, one of which was unsuccessful. The actual time of patency varies between 3 and 28 months. Conclusion: Our experience with the Hemodialysis Reliable Outflow device showed that it was a safe option for patients with central venous stenosis and was associated with good clinical and analytic outcomes.

Electrocardiography-controlled central venous catheter tip positioning in patients with atrial fibrillation

2018 ◽  
Vol 19 (6) ◽  
pp. 528-534 ◽  
Author(s):  
Folkert Steinhagen ◽  
Maximilian Kanthak ◽  
Guido Kukuk ◽  
Christian Bode ◽  
Andreas Hoeft ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Central Venous Catheter ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Catheter ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Catheter Tip ◽  
Tip Position ◽  
The Right

Introduction: A significant increase of the p-wave of a real-time intracavitary electrocardiography is a reliable and safe method to confirm the central venous catheter tip position close to the atrium. However, conflicting data about the feasibility of electrocardiography exist in patients with atrial fibrillation. Methods: An observational prospective case–control cohort study was set up to study the feasibility and accuracy of the electrocardiography-controlled central venous catheter tip placement in 13 patients with atrial fibrillation versus 10 patients with sinus rhythm scheduled for elective surgery. Each intervention was crosschecked with ultrasound-guided positioning via right supraclavicular fossa view and chest radiography. Ultrasound-guided supraclavicular venipuncture of the right subclavian vein and guidewire advancement were performed. A B-mode view of the superior vena cava and the right pulmonary artery was obtained to visualize the J-tip of the guidewire. The central venous catheter was advanced over the guidewire and the electrocardiography was derived from the J-tip of the guidewire protruding from the central venous catheter tip. Electrocardiography was read for increased p- and atrial fibrillation waves, respectively, and insertion depth was compared with the ultrasound method. Results: Electrocardiography indicated significantly increasing fibrillation and p-waves, respectively, in all patients and ultrasound-guided central venous catheter positioning confirmed a tip position within the lower third of the superior vena cava. Conclusion: Electrocardiography-guided central venous catheter tip positioning is a feasible real-time method for patients with atrial fibrillation. Combined with ultrasound, the electrocardiography-controlled central venous catheter placement may eliminate the need for postinterventional radiation exposure.

scholarly journals Chylothorax and Chylopericardium: A Complication of Long-Term Central Venous Catheter Use

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
James Livesay ◽  
Isaac Biney ◽  
J. Francis Turner
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Disease Patient ◽  
Vena Cava ◽  
Venous Catheter ◽  
Central Venous ◽  
Vena Cava Syndrome ◽  
Stage Renal Disease ◽  
End Stage

The development of chylothorax and chylopericardium is an uncommon complication of the long-term use of central venous catheters. We describe a unique case of an end stage renal disease patient on hemodialysis with a left jugular tunneled catheter who developed superior vena cava syndrome. Our patient presented with both a large pleural and pericardial effusion that despite drainage continued to reaccumulate. Further imaging with CT scan of the thorax revealed stenosis of the superior vena cava leading to recurrent chylothorax and chylopericardium.

The diagnostic value of multi-detector CT angiography for catheter-related central venous stenosis in hemodialysis patients

2020 ◽  
pp. 026835552095509
Author(s):  
Yuliang Zhao ◽  
Letian Yang ◽  
Yating Wang ◽  
Huawei Zhang ◽  
Tianlei Cui ◽  
...  
Keyword(s):  
Internal Jugular Vein ◽  
Superior Vena Cava ◽  
Subclavian Vein ◽  
Jugular Vein ◽  
Superior Vena ◽  
Vena Cava ◽  
Brachiocephalic Vein ◽  
Central Venous ◽  
Hemodialysis Catheter ◽  
Central Venous Stenosis

The objective is to compare Multi-detector CT angiography (MDCTA) and digital subtraction angiography (DSA) in diagnosing hemodialysis catheter related-central venous stenosis (CVS). During a period of 6 years, hemodialysis patients with suspected catheter related-CVS who received both MDCTA and DSA were retrospectively enrolled. We analyzed the sensitivity, specificity, accuracy, Cohen’s kappa coefficient (κ) and other diagnostic parameters for MDCTA compared to DSA. A total of 1533 vascular segments in 219 patients were analyzed. Among the 280 lesions identified by DSA, 156 were correctly identified by MDCTA. There were 124 false negative and 41 false positive diagnoses. MDCTA had a high specificity (96.73%) but a low sensitivity (55.71%), with a moderate inter-test agreement (κ = 0.5930). In stratified analyses of vascular segments, the specificities of MDCTA were 89.93% (superior vena cava), 98.95% (left brachiocephalic vein), 95.33% (right brachiocephalic vein), 99.53% (left subclavian vein), 97.61% (right subclavian vein), 97.13% (left internal jugular vein), and 95.86% (right internal jugular vein), while the sensitivities were 90.00%, 65.52%, 66.67%, 87.50%, 40.00%, 20.00% and 8.11%, respectively. Good to excellent inter-test agreement was observed for the superior vena cava (κ = 0.7870), left brachiocephalic vein (κ = 0.7300), right brachiocephalic vein (κ = 0.6610), and left subclavian vein (κ = 0.8700) compared with poor to low agreement for the right subclavian vein (κ = 0.3950), left internal jugular vein (κ = 0.1890), and right internal jugular vein (κ = 0.0500). MDCTA had a high specificity in diagnosing hemodialysis catheter related-CVS. Its sensitivity varied by central venous segments, with better performance in superior vena cava and brachiocephalic veins.

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