scholarly journals Computed Tomography-guided Sharp Needle Venous Recanalization of Chronic Clot

2018 ◽  
Vol 2 ◽  
pp. 1
Author(s):  
Shiraz Rahim ◽  
Nami Azar ◽  
Jon Davidson ◽  
Yasmine Ahmed
Keyword(s):  
Computed Tomography ◽  
Mediastinal Lymph Node ◽  
Superior Vena ◽  
Vena Cava ◽  
Chylous Ascites ◽  
Venous Access ◽  
Brachiocephalic Vein ◽  
Additional Tool ◽  
Denver Shunt ◽  
Sharp Needle

This article outlines a case performed at our institution that involved direct sharp recanalization of the superior vena cava (SVC) as a way to bypass chronic venous thrombus using a combination of ultrasound and computed tomography (CT) guidance. The case is of a patient requiring a Denver shunt for chronic chylous ascites. His prior shunts placed in the right internal jugular and subclavian veins became thrombosed repeatedly. His left subclavian vein was resected with subsequent occlusion of the graft. The brachiocephalic vein was narrowed likely after his mediastinal lymph node dissection. Revision of the Denver shunt could therefore only be done by directly cannulating into the proximal SVC away from the thrombosed right internal jugular vein. This case outlines the use of CT as an adjunct to standard ultrasound or fluoroscopic guided sharp needle recanalization which has not previously been described in the literature and offers clinicians an additional tool to help treat long-segment thrombus and preserve important vessels for venous access.

scholarly journals Single-Setting Superior Vena Cava Biopsy and Stenting Utilizing Cone Beam Computed Tomography as an Additional Tool

2021 ◽  
Vol 22 ◽  
Author(s):  
Daniel Yuxuan Ong ◽  
Lawrence Han Hwee Quek ◽  
Ivan Kuang Hsin Huang ◽  
Gavin Hock Tai Lim ◽  
Gabriel Chan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Superior Vena Cava ◽  
Cone Beam Computed Tomography ◽  
Superior Vena ◽  
Vena Cava ◽  
Cone Beam ◽  
Additional Tool

The left brachiocephalic vein ‘spur’: A cadaveric and contrast computed tomography study

2019 ◽  
Vol 34 (10) ◽  
pp. 690-697
Author(s):  
Hiroki Mitsuoka ◽  
Munekazu Naito ◽  
Yusuke Ohmichi ◽  
Makiyo Hagihara ◽  
Kanae Umemoto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Superior Vena ◽  
Vena Cava ◽  
Cadaveric Study ◽  
Brachiocephalic Vein ◽  
Left Brachiocephalic Vein ◽  
Computed Tomography Images ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Objectives This study investigated the presence of the ‘spur’ which separates the lumen in the left brachiocephalic vein (LBV). Method We macroscopically observed the lumen of the bilateral brachiocephalic veins and the superior vena cava in 56 cadavers. The samples were treated with haematoxylin and eosin staining and immunostaining using an α-smooth muscle action antibody. Contrast-enhanced computed tomography images from 170 subjects were analysed. Results The septal structure was found in only 7% of LBVs included in the cadaveric study and 1.2% of LBVs included in the contrast-enhanced computed tomography image analysis. In the cadaveric study, the septal structure was identified as a ‘spur’ using histopathology. In both studies, a non-septal structure was found in the right brachiocephalic vein. Conclusions This is the first report indicating the existence of an LBV ‘spur’.

scholarly journals Femoral placement of a totally implantable venous access port with spontaneous catheter fracture: case report

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Tomohiro Kondo ◽  
Shigemi Matsumoto ◽  
Keitaro Doi ◽  
Motoo Nomura ◽  
Manabu Muto
Keyword(s):  
Superior Vena ◽  
Vena Cava ◽  
Venous Access ◽  
Brachiocephalic Vein ◽  
Access Port ◽  
Femoral Site ◽  
First Case ◽  
Venous Access Port ◽  
The Right ◽  
Catheter Fracture

Abstract Background The incidence of catheter fracture after standard positioning of a totally implantable venous access port (TIVAP) is reported to be 1.1%–5.0%; however, the incidence of catheter fracture after TIVAP implantation at a femoral site remains unclear. Case presentation In a 30-year-old man with angiosarcoma of the right atrium, tumor embolism was observed from the left brachiocephalic vein to the superior vena cava. A TIVAP was implanted in the right femur. A catheter fracture was spontaneously observed after 7 months. Conclusions To the best of our knowledge, this is the first case of catheter fracture in a TIVAP implantation at a femoral site.

Re: Creating a TIPS in a patient with difficult venous access: Use of a nonfunctioning denver shunt to access an occluded superior vena cava

1999 ◽  
Vol 22 (3) ◽  
pp. 262-263
Author(s):  
Charles A. Owens ◽  
David Warner ◽  
Babak Yaghmai ◽  
Robert Dickstein ◽  
Enrico Benedetti ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Access ◽  
Difficult Venous Access ◽  
Denver Shunt

Placement of Tunnelled Hemodialysis Catheters across Stenotic and Occluded Central Veins

2003 ◽  
Vol 4 (1) ◽  
pp. 3-8 ◽  
Author(s):  
A. Falk ◽  
A. Alomari ◽  
J.E. Silberzweig
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Access ◽  
Catheter Insertion ◽  
Brachiocephalic Vein ◽  
Metallic Stent ◽  
Central Venous ◽  
Hemodialysis Catheter

Purpose The purpose of this study was to evaluate the efficacy of placement of tunneled hemodialysis catheters in patients with occluded or stenotic central veins. Materials and Methods Data were prospectively collected for 26 patients (11 male, 15 female, mean age 52 years) referred for placement of tunneled hemodialysis catheters with central venous stenoses or occlusions. The central venous occlusions or stenoses were recanalized using traditional interventional catheter and guidewire techniques. Results Thirty central venous access procedures were performed of which 28 (93%) procedures resulted in successful tunneled catheter insertion. Twenty-one internal jugular venous (13 right, 8 left) and 7 subclavian venous (3 right, 4 left) catheters were placed. Eighteen stenotic and 10 occluded venous segments were crossed including the brachiocephalic vein (n = 22), subclavian vein (n = 2), and the superior vena cava (4). One patient required insertion of a metallic stent to facilitate passage of the hemodialysis catheter across an occluded brachiocephalic vein. No procedure-related complications occurred. No episodes of upper extremity swelling or superior vena cava syndrome occurred following catheter insertion. Conclusion Insertion of tunneled hemodialysis catheter across occluded or stenotic central veins is technically feasible and safe. The use of occluded or stenotic central veins for catheter access preserves patent central veins for future shunt access.

A Giant Coronary Sinus Aneurysm with Secondary Vena Cava Aneurysms

2016 ◽  
Vol 19 (1) ◽  
pp. 028
Author(s):  
Shengjun Wu ◽  
Peng Teng ◽  
Yiming Ni ◽  
Renyuan Li
Keyword(s):  
Computed Tomography ◽  
Heart Transplantation ◽  
Coronary Sinus ◽  
Unusual Case ◽  
Superior Vena ◽  
Vena Cava ◽  
Final Diagnosis ◽  
Rare Entity ◽  
First Case ◽  
Enhanced Computed Tomography

Coronary sinus aneurysm (CSA) is an extremely rare entity. Herein, we present an unusual case of an 18-year-old symptomatic female patient with a giant CSA. Secondary vena cava aneurysms were also manifested. The final diagnosis was confirmed by enhanced computed tomography (CT) and cardiac catheterization. As far as we know, it is the first case that such a giant CSA coexists with secondary vena cava aneurysms. Considering the complexity of postoperative reconstruction, we believe that heart transplantation may be the optimal way for treatment. The patient received anticoagulant due to the superior vena cava (SVC) thrombosis while waiting for a donor.

Routine Chest Radiography Following Tunneled Hemodialysis Catheter: Use and Clinical Outcomes

2021 ◽  
Author(s):  
Mouafak J. Homsi ◽  
Ibrahim M. Hashim ◽  
Caroline M. Hmedeh ◽  
Boutros Karam ◽  
Jamal J. Hoballah ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Superior Vena Cava ◽  
Guide Wire ◽  
Superior Vena ◽  
Vena Cava ◽  
Real Life ◽  
Venous Catheter ◽  
Brachiocephalic Vein ◽  
Hemodialysis Catheter ◽  
Independent Reviewer

Highlights Abstract Background: A postoperative chest x-ray (CXR) remains part of some hospital protocols following tunneled hemodialysis catheter placement despite the use of operative imaging-guided techniques. The aim is to assess the usefulness of this practice and its impact on clinical outcomes and resource use. Methods: A review of medical records and postoperative CXR was done for 78 adult patients who had tunneled hemodialysis catheters placed in the operating room under fluoroscopy guidance. Catheters were inserted by ultrasound-guided puncture (51.3%) or exchanged from an existing catheter over a guide wire (48.7%). The postoperative CXRs were also examined by an independent reviewer to assess the catheter tip position and the need for repositioning to mimic a real-life postoperative setting. Procedural, nursing, and billing records were also reviewed. Results: No patients had a pneumothorax or major complications. On postoperative CXRs, 29 (37.2%) patients had the catheter tips in the right atrium, 23 (29.5%) in the cavoatrial junction, 25 (23.1%) in the superior vena cava, and 1 (1.3%) in the brachiocephalic vein. The independent reviewer found the catheter tips in acceptable anatomical positions in 75 of 78 patients. Only 3 (3.9%) patients had catheter malfunctions during dialysis and exchanged their catheters (2 had high catheters in the superior vena cava and brachiocephalic vein, 1 had a kinked catheter). Postoperative CXRs also caused delays in patient discharge from postanesthesia care units and significant increases in medical expenses (around $199 per patient). Conclusion: Routine CXR after tunneled hemodialysis central venous catheter insertion is unnecessary and does not add to the procedure's safety or to the patient's outcome.

scholarly journals Successful Resection of a Giant Pulmonary Colloid Adenocarcinoma via Median Sternotomy

2020 ◽  
Vol 13 (3) ◽  
pp. 1097-1102
Author(s):  
Daisuke Nakamura ◽  
Ryoichi Kondo ◽  
Akiko Makiuchi ◽  
Hiroko Itagaki
Keyword(s):  
Superior Vena Cava ◽  
Lung Tumor ◽  
Mediastinal Lymph Node ◽  
Superior Vena ◽  
Median Sternotomy ◽  
Vena Cava ◽  
Cystic Mass ◽  
Field Of View ◽  
Surgical Field ◽  
The Right

We report on a giant pulmonary colloid adenocarcinoma successfully resected using a median sternotomy approach. A 69-year-old woman visited our hospital owing to a giant mass detected on chest radiography. A giant cystic mass measuring 115 × 90 mm was detected in the right upper lung using computed tomography. We suspected mucinous adenocarcinoma and performed right upper lobectomy and mediastinal lymph node dissection with median sternotomy. The surgical field of view for the tumor and superior vena cava was satisfactory, and compression but not invasion of the superior vena cava and chest wall by the tumor was observed. The tumor was pathologically diagnosed as a colloid adenocarcinoma of stage IIIA with pT4N0M0. The postoperative course was uneventful, with no signs of recurrence at one and a half years after operation. Thus, this case demonstrates that for giant lung tumor surgery, median sternotomy is useful and safe for improving the surgical field of view.

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