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Persistent left superior vena cava with thrombus formed in the catheter lumen 4 h after dialysis catheter placed

Tomoki Kawasaki1, Hiroyuki Tanaka2, Miki Oba2

  • 1Department of Nephrology, Soka City Hospital, 2-21-1 Soka, Soka, Saitama, 340-8560, Japan. kssbh81@yahoo.co.jp.

CEN Case Reports
|February 19, 2018
PubMed

Insights

Persistent left superior vena cava (PLSVC) is a common anomaly. In this case, a hemodialysis catheter in a patient with PLSVC developed thrombosis shortly after placement, highlighting a potential complication.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Nephrology

Background:

  • Persistent left superior vena cava (PLSVC) is a common congenital thoracic venous anomaly.
  • It is often asymptomatic but can be encountered during central venous catheter placement.
  • Nephrologists frequently encounter PLSVC when placing hemodialysis catheters via the jugular vein.

Purpose of the Study:

  • To report a case of intrinsic thrombosis formation in a hemodialysis catheter placed in a patient with PLSVC.
  • To discuss the implications of PLSVC for central venous catheterization in nephrology.

Main Methods:

  • Case report of a 66-year-old patient with PLSVC.
  • Hemodialysis catheter placement in the left internal jugular vein.
  • Catheter removal and examination of the catheter lumen.
  • Transesophageal echocardiography.

Main Results:

  • A hemodialysis catheter was placed without immediate complication in a patient with PLSVC.
  • Thrombus formation was identified within the catheter lumen 4 hours after placement.
  • Transesophageal echocardiography ruled out thrombus within the heart chambers.

Conclusions:

  • Patients with PLSVC undergoing central venous catheterization are at risk for catheter-related thrombosis.
  • If alternative venous access is available, catheter replacement should be considered in patients with PLSVC presenting with thrombosis.
  • Awareness of PLSVC is crucial for nephrologists to prevent and manage potential complications during catheter placement.

Keywords:
CatheterDialysisPersistent left superior vena cavaThrombosis

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