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Transhepatic Tunneled Catheter Using Left Hepatic Vein: The Last Resort for Dialysis
Masa Abaza1, Sloan E Almehmi2, Ammar Almehmi3
1Department of Biology, University of Alaska Anchorage, Anchorage, AK, USA.
Clinical Medicine Insights. Case Reports
|January 6, 2022
Summary
This case report details a novel use of the left hepatic vein for transhepatic dialysis access in a patient with end-stage renal disease who exhausted traditional options. This approach offers a potential solution for challenging vascular access cases.
Area of Science:
- Nephrology
- Vascular Surgery
- Interventional Radiology
Background:
- Vascular access is critical for hemodialysis in end-stage renal disease (ESRD) patients.
- Arteriovenous fistulas and grafts are standard, but not always feasible.
- Patients may exhaust traditional vascular access routes, necessitating alternative strategies.
Observation:
- A 66-year-old female patient with ESRD had no remaining traditional vascular access options.
- Recurrent femoral catheter infections, calciphylaxis, and body habitus complicated further access.
- A transhepatic approach was chosen, specifically utilizing the left hepatic vein, a route not previously documented.
Findings:
- The left hepatic vein was successfully used for transhepatic dialysis catheter insertion.
- This novel approach aimed to circumvent complications associated with previous access sites, such as skin lesions.
Implications:
- This case highlights the challenges in securing reliable vascular access for hemodialysis.
- The use of the left hepatic vein represents a potential alternative for complex cases.
- Further research into less common vascular access routes is warranted for challenging ESRD populations.
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