Catheter-related right internal jugular vein large thrombus formation after inadvertently malposition in the cranial direction

Ma, Wenqiang; Qiu, Yuxue; Cui, Yu; Yang, Guangfei; Wang, Zhitao; Liu, Bin

doi:10.1007/s11239-019-01877-y

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…We searched PubMed using the keywords (internal jugular vein AND catheter AND thrombophlebitis OR thrombosis) and excluded reports with no description of symptoms, treatment, or complications. We retrieved 12 relevant articles (Table 1) [10][11][12][13][14][15][16][17][18][19][20][21]. These articles included 14 patients with catheter-related IJV thrombosis, but only three cases of thrombophlebitis [10,11,13].…”

Section: Discussionmentioning

confidence: 99%

Two cases of aseptic internal jugular vein thrombophlebitis associated with hemodialysis catheter, presenting as sore throat: case report and literature review

et al. 2023

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Background Non-cuffed hemodialysis (HD) catheters are often used for emergency or temporary vascular access. Its complications include thrombosis and catheter-related bloodstream infection (CRBSI); however, thrombophlebitis can also occur. Thrombophlebitis of the internal jugular vein (IJV) may present with symptoms, such as fever, lateral neck pain, and swelling, regardless of the presence or absence of infection; however, symptoms may be minor and easily overlooked. Sore throat is a well-known symptom of Lemierre's syndrome, but has not been reported in cases of thrombophlebitis without infection. We report two cases of HD catheter-associated IJV thrombophlebitis in patients that were diagnosed with sore throat. Case presentation Case 1 included a 58-year-old woman with diabetic nephropathy on HD. She was admitted to our hospital due to the occlusion of an arteriovenous fistula (AVF) for dialysis. A temporary HD catheter was placed in the right IJV until an arteriovenous graft (AVG) was fabricated. After admission, CRBSI was suspected because she developed fever; however, bacteremia was ruled out and a sore throat gradually developed. Contrast-enhanced computed tomography (CT) revealed thrombophlebitis of the right IJV. Anticoagulation therapy was initiated and she was discharged due to an improvement of symptoms. Case 2 included an 83-year-old man with end-stage renal disease due to hypertensive nephrosclerosis. He was admitted to our hospital because of AVF occlusion. A temporary HD catheter was inserted into the right IJV and an AVG was created. He had elevated C-reactive protein levels after catheter placement but was asymptomatic. When removing the catheter, he complained of throat discomfort. Ultrasonography of the neck revealed thrombotic obstruction of the right IJV, and contrast-enhanced CT revealed thrombophlebitis of the right IJV. Blood culture results were negative. He was discharged after anticoagulation therapy was started and symptoms improved. Conclusions The presence of sore throat leads to the diagnosis of IJV thrombophlebitis. Pharyngeal symptoms that develop after central venous catheter (CVC) placement should be differentiated from thrombophlebitis using a minimally invasive vascular ultrasound.

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Section: Discussionmentioning

confidence: 99%

Two cases of aseptic internal jugular vein thrombophlebitis associated with hemodialysis catheter, presenting as sore throat: case report and literature review

et al. 2023

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“…EJVB can reduce bleeding without the need for whole-body heparinization and achieve complete tumor resection, which is conducive to the operation. Previous studies [10][11][12] have found that this method is easy to operate with excellent controllability, allowing for stable hemodynamics, lower SVC pressure during occlusion, and reduced bleeding. In terms of anesthesia monitoring, continuous monitoring of arterial blood pressure, IJV pressure, dynamic monitoring of arterial blood gas (ABG), and blood glucose levels are necessary to promptly assess cerebral oxygen metabolism.…”

Section: Discussionmentioning

confidence: 99%

Anesthesia Management of a Patient with Papillary Thyroid Carcinoma Recurrence and Metastasis to the Right Atrium and Superior Vena Cava: A Case Report

Xiong

2023

Asp Biomed Clin Case Rep

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Postoperative recurrence and metastasis of papillary thyroid carcinoma (PTC) to the superior vena cava (SVC) and right atrium (RA) are rare. The application of Extracorporeal Jugular-femoral Vein Bypass and anesthesia management for SVC reconstruction in this rare situation holds instructive significance. In this case, we describe the successful anesthesia management of a patient with multiple tumor thrombi due to postoperative recurrence of PTC. The diagnosis was based on computed tomography of the chest and blood vessels, revealing three-dimensional SVC, postoperative recurrence of PTC, and multiple tumor thrombi in the internal jugular vein (IJV), subclavian vein, brachiocephalic vein, SVC, and RA. An experienced multidisciplinary team was established, and a detailed plan was made for respiration and circulation support, with cardiopulmonary bypass on standby.

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“…PWO is a not uncommon complication of totally implantable venous access devices (TIVADs). It may be secondary to at least six causes: (a) the presence of fibroblastic sleeve, which may surround the catheter and close its tip with a ball-valve effect (so called ‘fibrin tail’, sometimes detected incidentally during an echocardiography performed for other purposes); 1 (b) a malposition of the catheter tip, which may be stuck against the wall of the superior vena cava or located in a small secondary vein: in both situations, infusion is possible but when trying to aspirate the tip ‘sucks’ the wall of the vein and blood withdrawal becomes impossible; (c) the presence of a catheter-related thrombosis around the tip of the catheter (event usually associated with a primary or secondary malposition of the tip); 2,3 (d) the use of a catheter with a distal valve, such as the Groshong catheter: these catheters are notoriously prone to malfunction, both because the valve becomes rapidly incontinent, and also because the opening pressure in aspiration is ill-defined and unreliable; 4 (e) a ‘pinch-off’ syndrome, i.e., a compression of the catheter in its extravascular tract, between clavicle and first rib, typically secondary to a ‘blind’ infraclavicular puncture to the subclavian vein; 5 (f) finally, PWO may be also due to intraluminal obstruction, in the case that the clots or the drug precipitates create a ball-valve effect inside the lumen of the catheter.…”

Section: Introductionmentioning

confidence: 99%

An ultrasound-based technique in the management of totally implantable venous access devices with persistent withdrawal occlusion

2021

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Persistent withdrawal occlusion is a specific catheter malfunction characterized by inability to withdraw blood through the device while infusion is maintained. The main causes are fibroblastic sleeve and tip malposition (associated or not to venous thrombosis around the tip). All current guidelines recommend infusing vesicant/antiblastic drugs through a central venous port only after assessment of blood return. In PWO, blood return is impossible. We have recently started to assess the intravascular position of the tip and the delivery of the infusion in the proximity of the cavo-atrial junction utilizing transthoracic/subxiphoid ultrasound with the ‘bubble test’. We found that this is an easy, real-time, accurate and safe method for verifying the possibility of using a port for chemotherapy even in the absence of blood return, as it occurs with persistent withdrawal occlusion.

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Catheter-related right internal jugular vein large thrombus formation after inadvertently malposition in the cranial direction

Cited by 4 publications

References 8 publications

Two cases of aseptic internal jugular vein thrombophlebitis associated with hemodialysis catheter, presenting as sore throat: case report and literature review

Two cases of aseptic internal jugular vein thrombophlebitis associated with hemodialysis catheter, presenting as sore throat: case report and literature review

Anesthesia Management of a Patient with Papillary Thyroid Carcinoma Recurrence and Metastasis to the Right Atrium and Superior Vena Cava: A Case Report

An ultrasound-based technique in the management of totally implantable venous access devices with persistent withdrawal occlusion

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