Cerebral Infarction due to Central Vein Occlusion in a Hemodialysis Patient

Prasad, Vikram; Baghai, Shahine; Gandhi, Dheeraj; Moeslein, Fred; Jindal, Gaurav

doi:10.1111/jon.12152

Cited by 21 publications

(28 citation statements)

References 9 publications

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“…16 Laterality of insertion has consistently been reported to be a predictor of CVLs. 2,25 In our study, 26 of the 41 patients (about twothirds) who underwent central vein catheterization developed an ipsilateral CVL.…”

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confidence: 65%

“…The factors that were investigated in relation to CVLs were described using frequency distribution for categorical variables and mean ± standard deviation for continuous variables. Pearson's chi-square (χ 2 ) tests were used to analyze the associations between categorical variables, and Student's t-tests were used for continuous variables. In addition, logistic regression analysis was used to determine the main predictors of CVL in the study model, and P<0.05 was considered statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…Central venous lesions (CVLs) are somewhat clinically overlooked, and their true incidence is likely underestimated [1][2][3] In developing countries such as Jordan, a lack of access monitoring protocols and surveillance of access-related issues serves as a challenge to access circuit patency. Consequently, diagnosis is limited to symptomatic patients with intractable complications that are mostly related to upper limb edema and inadequate dialysis.…”

Section: Introductionmentioning

confidence: 99%

“…1,5,6 The severity of symptoms remains to be unpredictable and poorly understood. 2 Studies on various patient-, intervention-, and access-related features such as previous central catheterizations, venous collaterals, lesion-related characteristics (eg, lesion location including stenotic and obstructive lesions), access flow, and type and site of vascular access have been published. 2,4,[7][8][9][10] Furthermore, the etiopathogenesis of CVLs was determined to be multifactorial and controversial.…”

Section: Introductionmentioning

confidence: 99%

“… 2 Studies on various patient-, intervention-, and access-related features such as previous central catheterizations, venous collaterals, lesion-related characteristics (eg, lesion location including stenotic and obstructive lesions), access flow, and type and site of vascular access have been published. 2 , 4 , 7 – 10 Furthermore, the etiopathogenesis of CVLs was determined to be multifactorial and controversial. Proposed mechanisms of CVL development include endothelial trauma due to repeat catheterizations, uremic milieu, flow dynamics with increased shear stress, platelet dysfunction, and intimal hyperplasia with fibrotic response, and these mechanisms may act synergistically.…”

Section: Introductionmentioning

confidence: 99%

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<p>Lesion Type Analysis of Hemodialysis Patients Who Underwent Endovascular Management for Symptomatic Central Venous Disease</p>

Aljarrah¹,

Allouh²,

Hallak³

et al. 2020

VHRM

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Purpose: Central venous lesions (CVLs) can adversely affect hemodialysis access maturation and maintenance, which in turn worsen patient morbidity and access circuit patency. In this study, we assessed several clinical variables, patient characteristics, and clinical consequences of symptomatic central vein stenosis and obstruction in patients who underwent renal replacement therapy in the form of hemodialysis. Patients and Methods: The medical records of all hemodialysis patients with clinically symptomatic CVLs who underwent digital subtraction angiography treatment at King Abdullah University Hospital between January 2017 and December 2019 were retrieved. Patient characteristics and the clinical and anatomical features of CVLs were analyzed retrospectively. Pearson's chi-square tests of association were used to identify and assess relationships between patient characteristics and CVLs. Results: The study cohort comprised 66 patients with end-stage renal disease who developed symptomatic central vein stenosis. Of the 66 patients, 56.1% were men, and their mean age was approximately 52 years. Most (62.1%) of the patients were determined to have a history of central catheter insertion into the jugular vein. Hypertension was the most common comorbidity (78.8%, p<0.001), followed by type 2 diabetes mellitus (47.0 %, p<0.01). The incidence of stenosis was found to be significantly higher in the brachiocephalic vein than in other central veins (43.9%, p<0.001). A repeated central catheter insertion in a patient was predictive of central venous occlusion (p<0.05). Stenotic lesions were found to be associated with a significantly higher success rate than occlusive lesions (91.2%, p<0.01). Conclusion: Multiple central venous catheters (CVCs) are found to be associated with occlusive CVLs and unfavorable recanalization outcomes. Multiple CVC should be avoided by creating a permanent vascular access in a timely fashion for patients with chronic kidney disease and by avoiding the ipsilateral insertion of CVC and AVF.

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confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

<p>Lesion Type Analysis of Hemodialysis Patients Who Underwent Endovascular Management for Symptomatic Central Venous Disease</p>

Aljarrah¹,

Allouh²,

Hallak³

et al. 2020

VHRM

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A rare hemodialysis vascular access complication—Internal jugular vein reflux

Xiong,

Zhang

2024

J of Clinical Ultrasound

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Hemodialysis (HD) arteriovenous fistulas commonly present with late vascular access complications, but are rarely in association with internal jugular vein (IJV) reflux. We reported two patients who had severe and mild IJV reflux, respectively. Case 1 was a 48‐year‐old male with end‐stage renal disease (ESRD) who had been treated with HD for 5 years. He presented with persistent headaches, nausea, and vomiting. Combined with all the examinations, it was revealed severe IJV reflux, brachiocephalic vein stenosis, high‐flow vascular access, and IJV valve dysfunction. Case 2 was a 59‐year‐old female with ESRD who had constructed an AVF for 4 months and had been on HD for only 1 day. She presented with dizziness and nausea after the first hemodialysis and duplex ultrasonography showed slightly continuous IJV reflux, high‐flow vascular access, and IJV valve dysfunction. Furthermore, we reviewed 16 case reports to identify the characteristics of IJV reflux in HD patients. IJV reflux in HD patients may be caused by high‐flow access, central venous stenosis or occlusion, and valve dysfunction. Severe IJV reflux can develop neurological symptoms secondary to intracranial venous reflux in this article. Etiological treatment is helpful for these patients, but there is a risk of recurrence.

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