Publicação
Rescuing the nephrologists main central vein - placement of a right jugular vein catheter in a patient with thoracic central venous occlusion by use of the Surfacer® device
| Resumo: | Introduction: Central venous stenosis can be the main obstacle to the creation of a vascular access. The Surfacer® device was developed to solve the problem of complete occlusions of the right internal jugular vein, right brachiocephalic vein and superior vena cava, allowing for the placement of a vascular access in this venous axis. Case Report: We present the case of a 77-year-old patient on long-term hemodialysis with a long history of failed vascular accesses and of central vein stenosis, chronically dialyzed using a tunneled catheter placed through the left femoral vein. With use of the Surfacer® device it was possible to recreate, with an inside-out technique, a tract through the fibrous tissue of the completely occluded right brachiocephalic and right internal jugular veins, subsequently placing a tunneled catheter into the right atrium through this later vein. Conclusion: We report the first successful use in Portugal of a new vascular access device that allows us to rescue a previous unusable right central venous axis for the placement of a central venous catheter, thus avoiding the use of less advantageous options such as the femoral veins and preserving venous vascular capital. |
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| Autores principais: | Afonso,Nuno |
| Outros Autores: | Rodrigues,Luís; Ferreira,Emanuel; Pinto,Helena; Nogueira,Rui; Anacleto,Gabriel; Fonseca,Manuel; Alves,Rui |
| Assunto: | Central Venous Occlusion Central Veins Surfacer |
| Ano: | 2020 |
| País: | Portugal |
| Tipo de documento: | relatório |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Fundação para a Ciência e Tecnologia |
| Idioma: | inglês |
| Origem: | SciELO Portugal |
| Resumo: | Introduction: Central venous stenosis can be the main obstacle to the creation of a vascular access. The Surfacer® device was developed to solve the problem of complete occlusions of the right internal jugular vein, right brachiocephalic vein and superior vena cava, allowing for the placement of a vascular access in this venous axis. Case Report: We present the case of a 77-year-old patient on long-term hemodialysis with a long history of failed vascular accesses and of central vein stenosis, chronically dialyzed using a tunneled catheter placed through the left femoral vein. With use of the Surfacer® device it was possible to recreate, with an inside-out technique, a tract through the fibrous tissue of the completely occluded right brachiocephalic and right internal jugular veins, subsequently placing a tunneled catheter into the right atrium through this later vein. Conclusion: We report the first successful use in Portugal of a new vascular access device that allows us to rescue a previous unusable right central venous axis for the placement of a central venous catheter, thus avoiding the use of less advantageous options such as the femoral veins and preserving venous vascular capital. |
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