Unusual venous anomaly leading to malposition of dialysis catheter into the accessory hemiazygos vein

Oye, Monique; Torrente, Natalie; Lyons, Brittany; Aung, Win

doi:10.1136/bcr-2020-238264

Cited by 1 publication

(2 citation statements)

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“…In the present case, as reported by others, 3,12 blood outflow of the misplaced catheter was too poor to support HD. In one of the reported cases, the catheter could be successfully repositioned.…”

Section: Discussionsupporting

confidence: 63%

“…In one of the reported cases, the catheter could be successfully repositioned. 12 When the catheter does work properly, it is more difficult to recognize that it is in the LSIV or other aberrant location unless a control chest X-ray is available. Interestingly, Kamiński et al 5 reported the utilization of the LSIV for placement of an HD tunneled catheter in a 68-year-old male patient with totally exhausted conventional central venous approaches for catheterization.…”

Section: Discussionmentioning

confidence: 99%

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Acute hemodialysis catheter follows the path of least resistance

Salgado

Vachharajani

2021

J Vasc Access

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The placement of large bore double-lumen catheters for hemodialysis (HD) is one of the most frequent procedures performed in HD patients. However, these procedures are associated with complications, the most common being catheter malposition. In this context, catheter deviation to the left superior intercostal vein (LISV) is a very uncommon malposition, which must be differentiated from intrathoracic extravascular catheter lodgment. We report a case of an adult male patient on hemodialysis who presented with a thrombosed arteriovenous fistula and requiring urgent HD. His past medical history included hemophilia, allergy to contrast media, and multiple previous central vein catheterizations. A non-tunneled HD catheter was placed without any difficulty in the left internal jugular vein. However, the arterial lumen failed to pull any blood with free flow in the venous lumen. A chest X-ray revealed a surprising finding. The malpositioned catheter was removed successfully without any complications.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%