Malposition of hemodialysis catheter into the hepatic veins: A case report

Area of Science:

• Nephrology
• Vascular Surgery
• Medical Imaging

Background:

• Permanent central vein catheters are a common hemodialysis vascular access option.
• Catheters can be inserted via jugular, subclavian, or femoral veins.
• Indications include short life expectancy or unsuitability for fistula creation.

Observation:

• A 44-year-old female hemodialysis patient presented with a malpositioned permanent catheter.
• The catheter was inserted three months prior to presentation.
• Imaging revealed the catheter tip located within the hepatic vein.

Findings:

• The central venous catheter, intended for hemodialysis, was found malpositioned.
• The catheter tip migrated or was initially placed in the hepatic vein, not the central circulation.
• This malpositioning occurred despite the catheter being in situ for three months.

Implications:

• Malpositioned hemodialysis catheters pose risks and may necessitate intervention.
• Hepatic vein catheterization can lead to complications distinct from standard central venous access.
• This case underscores the importance of post-insertion imaging and monitoring for permanent dialysis catheters.