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Anatomy Revisited: Hemodialysis Catheter Malposition into the Chest

Pan Xie1,2,3, Kanfu Peng4, Keqin Zhang1

  • 1Department of Nephrology, Southwest Hospital, The First Affiliated Hospital of Army Military Medical University, Chongqing, China.

Blood Purification
|September 18, 2018
PubMed

Insights

Central venous catheter placement for hemodialysis can lead to complications like stenosis and misplacement. This case highlights the risk of great vein perforation and catheter migration into the chest, emphasizing the need for imaging verification.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Radiology

Background:

  • Central venous catheters are crucial for hemodialysis access.
  • Commonly placed in the right jugular vein, they are prone to stenosis and thrombosis after repeated use.
  • These complications increase the risk of catheter misplacement.

Observation:

  • A case report details a 77-year-old patient experiencing hemodialysis catheter malpositioning.
  • A cuffed-tunneled catheter placed in the left internal jugular vein migrated.
  • The malpositioned catheter perforated great veins, with its tip migrating into the chest.

Findings:

  • Incorrect positioning of dialysis catheters poses significant risks.
  • Vessel wall stenosis and fragility increase the likelihood of perforation.
  • Timely verification of catheter placement via imaging is essential.

Implications:

  • Awareness of potential malpositioning complications is crucial for clinicians.
  • Imaging confirmation of internal jugular vein catheter placement is recommended before initiating hemodialysis.
  • This case highlights the need for vigilance in central venous catheter management.

Keywords:
ChestCuffed-tunneled hemodialysis catheterDialysis catheterInternal jugular veinMalpositionVascular access

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