Tunnelled haemodialysis catheter insertion into the persistent left superior vena cava

Area of Science:

• Vascular Medicine
• Anatomical Variations
• Interventional Cardiology

Background:

• Persistent left superior vena cava (PLSVC) is a rare congenital anomaly of the thoracic venous system.
• It is often discovered incidentally during procedures like central venous catheterization or pacemaker implantation.
• Understanding PLSVC is crucial for safe and effective venous access.

Observation:

• A patient presented with an attempted insertion of a tunnelled haemodialysis catheter via the left internal jugular vein.
• The procedure led to the incidental diagnosis of a persistent left superior vena cava.
• Cardiac echography and angio-computed tomography confirmed the anatomical variation.

Findings:

• A 19-cm tunnelled haemodialysis catheter was successfully inserted into the persistent left superior vena cava.
• The catheter demonstrated good long-term function despite the unusual venous anatomy.
• This case highlights the feasibility of utilizing PLSVC for dialysis access.

Implications:

• The findings suggest that persistent left superior vena cava should be considered in cases of difficult central venous access.
• Successful catheterization in PLSVC can provide a viable long-term vascular access option for hemodialysis.
• This case expands the understanding of managing venous anomalies in interventional procedures.