Hemodialysis Catheter Malposition Induced by a Brachiocephalic Vein Stenosed Stent

Abstract

Malposition of a central venous hemodialysis catheter, mainly due to central vein stenosis or thrombosis, is not an uncommon complication. Herein, we present a rare cause of a left external jugular vein hemodialysis catheter, malpositioned into the ipsilateral internal jugular-subclavian venous route, due to a stenosed stent that has been placed into the ipsilateral brachiocephalic vein.

Malposition of hemodialysis catheter into the hepatic veins

“…The NKF-DOQI guideline recommends routine chest X-rays to detect potential complications and to verify the placement of the catheter after jugular and subclavian catheter insertion 5. The distal tip of the malpositioned catheter may be localized in an improper vein (contralateral subclavian, contralateral brachiocephalic or internal mammarian vein) 6. Internal thoracic vein, the internal mammarian vein and the pulmonary arteries are the most reported locations for malpositioned central venous catheters.…”

Central Venous Catheter Malpositions in Pediatric Patients: Two Case Reports

“…Santral kateterler avantajlarının dışında yakın takip edilmelerini gerektiren ciddi komplikasyonlara da neden olabilmektedirler. İşlem sırasında oluşabilecek pnömotoraks ve hemotoraks gibi hayati mekanik komplikasyonlar dışında kateter ucu yerleşimine bağlı gelişebilecek komplikasyonlar da literatürde bildirilmektedir (6)(7)(8). Kateter ucunun işlem sonrası radyolojik doğrulanması kılavuzlarda olmakla birlikte radyolojik doğrulamanın her uygulamada gerekli olmadığını veya endokaviter elektrokardiyografi (EKG) gibi yöntemlerle radyolojik yöntemlere ihtiyacın azalacağını savunan çalışmalar da mevcuttur (9)(10)(11)(12).…”

Rare Malpositions Following Insertion of the Left Jugular Vein Catheterization: Case Reports and Literature Review

“…The malposition is more likely to occur in the split-tipped catheter through the left IJV because left-sided catheter placement meets serious challenge: longer passage and more bends to the desired location, by contrast to the right one (20)(21). Dual-lumen catheters on the left-sided predispose to bifurcate between lumens passing though curved path (2,5,20). It is appeared that the arterial lumen is easier to kink, overlap or reentrant in the vein even step to other vein for lack of wire guidance during the advance of catheter, while venous lumen is not for the guide-wire passing through.…”

“…Various complications of centralvenous catheterization have been reported while the most common complications arise from insertion of the catheter include pneumothorax, misplacement, arterial puncture, local infection, hematomas, and thrombosis (1)(2)(3)(4). Malposition of a central venous haemodialysis catheter is an uncommon complication (4%), requiring appropriate management (5).…”

“…It is reported that cannulation of the left IJV is more difficult and associated with more malpositions even than the right one (3,4). One reason is that left brachiocephalic vein is anatomically longer and has more smaller tributaries than the right one (2,3). Another reason is that left tributaries anatomically anastomose with the brachiocephalic vein (8).…”