Imaging features of azygos vein migration of haemodialysis catheter and repositioning using the modified loop-snare technique

Migration of a haemodialysis catheter is an uncommon complication that may compromise dialysis efficacy and patient safety. This report describes a case of haemodialysis catheter tip migration into the azygos vein. A man in his 40s presented with progressive dyspnoea and reduced extracorporeal blood flow during haemodialysis. Chest radiography revealed that both limbs of the left internal jugular tunnelled haemodialysis catheter had migrated to the right brachiocephalic vein and azygos vein, respectively, causing inefficient dialysis. The catheter was successfully repositioned using the modified loop-snare technique, involving a wire loop created with a reverse-curve catheter and goose-neck snare to address the kinked limb. This case underscores the importance of recognising catheter migration and the problem-solving skills of an interventionist. The modified loop-snare technique is an effective, minimally invasive method to reposition migrated haemodialysis catheters, avoiding cuff dissection and a new subcutaneous tunnel creation.