Tunneled‐cuffed catheter implanted into the accessory hemiazygos vein because of occlusion of the left innominate vein

Abstract

Hemodialyzed patients are at risk of multiple catheterizations. Nephrologists performing such procedures need to be familiar with congenital and acquired vascular abnormalities. We describe a successful insertion and use of a cuffed-tunneled catheter in a patient with unusual anatomy of the central venous system. Computed tomography angiography revealed thrombosis of the right subclavian vein and bilateral occlusion of innominate veins. The left internal jugular and subclavian veins joined to form a large vessel that drained through the accessory hemiazygos and azygos veins into the superior vena cava. The catheter was implanted through the left internal jugular vein into the accessory hemiazygos vein. The presented case demonstrates that the catheter can be implanted into distended collateral, especially when no other location is possible.

Successful tunneled catheter placement in a hemodialysis patient with idiopathic multiple central venous stenoses

“…17 Literature survey also identified reports on central venous catheter implanted through the left internal jugular vein into the accessory hemi-azygos vein, indicating that distended collateral could be considered as inserting sites, especially when no other location is possible. 18 In conclusion, we report on a senile hemodialysis patient with idiopathic multiple CVSs unrelated to previous catheterization, fistula shunt flow, or extrinsic compression. Nephrologists should be aware of idiopathic CVS and its impact on the creation and preservation of vascular access.…”

“…Traditional surgery is effective for CVS untreatable by interventional means, but the comorbidity and mortality rate remain high . Literature survey also identified reports on central venous catheter implanted through the left internal jugular vein into the accessory hemi‐azygos vein, indicating that distended collateral could be considered as inserting sites, especially when no other location is possible …”

Sharp recanalization of the brachiocephalic vein occlusion through the external jugular vein in hemodialysis patients

“…In nephrology practice, brachiocephalic vein occlusion is encountered as a central venous complication among hemodialysis patients on a daily basis (13,14). While the mainstream treatment of brachiocephalic vein occlusion is interventional angioplasty, other therapeutic options include surgical bypass, sharp recanalization, radiofrequency recanalization and outback reentry device.…”