Thoracic venous anomalies without congenital heart anomalies are present in minority of the population, but they are frequent enough to be encountered while placing hemodialysis catheters through the jugular or subclavian veins. Persistent left superior vena cava is the most commonly seen anomaly and it is rarely noticed before the observation of an unusual course of hemodialysis catheter or guidewire on chest X-ray. We present two patients with previously unspotted persistent left superior vena cava and uncomplicated hemodialysis catheter insertions through the internal jugular veins with good catheter functions. Review of the relevant literature from a nephrologists' perspective with technical aspects is provided.

The addition of high-efficiency hemodialysis during cardiopulmonary resuscitation may contribute to the return of spontaneous circulation in patients with severe metabolic acidosis due to intoxication.

AE following catheter removal carries a major risk of mortality. Great awareness and attention to preventive procedures and appropriate care after development of AE seem mandatory.

Weak evidence is present for choosing amongst different temporary hemodialysis catheter (THC) designs with regards to the risk of venous thrombosis, therefore two THC designs for the right internal jugular vein (RIJV) were compared. Patients aged ≥18 years who needed THC insertion into the RIJV for acute hemodialysis due to either acute or chronic renal failure were included. The type of THC (precurved/straight) was dependent on the date of hospital admission. Clinical and ultrasonographic surveillance was conducted prospectively. Thrombosis of the RIJV was the primary objective. Precurved and straight catheters were inserted into 32 and 23 patients (mean age 63 ± 15 years, females 28), respectively. The baseline characteristics and catheter dwell‐times were similar in both groups. Partial and total thrombosis of the RIJV during catheter dwell‐time developed at a higher rate in the straight group (52% vs. 9.3%, P = 0.000; 47.8% vs. 9.3%, P = 0.001, respectively). At least 2 weeks after catheter removal, total thrombosis was found in 43.4% vs. 9.6% (P = 0.004) of patients with straight and precurved THCs, respectively. The hazard ratios for total thrombosis was 0.161 (P = 0.006) during catheter dwell‐time and 0.190 (P = 0.012) after catheter removal. Catheter dysfunction did not occur and only one catheter‐related bloodstream infection (CRBI) was seen. Thrombosis rates of the RIJV were higher with straight vs. precurved THCs, both during catheter dwell‐time and after catheter removal. Catheter dysfunction was not noted in any group and the rate of CRBI was extremely low.

Objective: This study aimed to analyze the role of chronic thromboembolic pulmonary hypertension (CTEPH) in patients with persistent chest symptoms after acute PE. Methods: Patients aged between 18 and 80 years who were followed up for acute PE were screened for chest symptoms which persisted after the anticoagulation treatment. Patients suffering other types of pulmonary hypertension (PH) or metastatic malignancies were excluded in this study. Demographic and functional data of patients included this study were collected. The patients underwent transthoracic echocardiography and ventilation/perfusion (VQ) scans. Also, invasive hemodynamic studies were done to patients with intermediate/high probability of VQ scans. Results: Of the 140 patients screen for this study, 29 patients (Female/Male=16/13) with mean age of 56.1±11.2 years and follow-up time of 35.1±17.7 months met the inclusion criteria. The mean systolic pulmonary artery blood pressure (sPAP) on transthoracic echocardiography was 28.9±4.9 mm Hg (range=20–40 mm Hg). Furthermore, intermediate or high probability of VQ scans was detected in 2 patients, who were subsequently diagnosed with CTEPH (6.9%) via right heart catheterization. Conclusion: CTEPH was diagnosed at a low rate in patients with persistent chest symptoms after the anticoagulation treatment for PE. CTEPH is still an elusive entity, which requires a multidisciplinary and invasive approach.