Brachiocephalic Vein Occlusion from a Tunneled Hemodialysis Catheter
Brachiocephalic Vein Occlusion from a Tunneled Hemodialysis Catheter
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DOI：
10.2169/internalmedicine.3354-19
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发表时间：
2019-07
影响因子：
1.2
通讯作者：
Naohiro Toda;S. Asada;T. Komiya
中科院分区：
文献类型：
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作者：
Naohiro Toda;S. Asada;T. Komiya
一名接受血液透析的 81 岁女性因右前臂动静脉移植物 (AVG) 血栓入院。入院前一年，将隧道式血液透析导管置于右颈内静脉中。该导管已被拔除，并在入院前六个月制作了 AVG。计算机断层扫描显示右侧头臂静脉和颈内静脉闭塞（星号和箭头，图 1）。这些闭塞被认为是由隧道式血液透析导管引起的 (1)。为了恢复 AVG 血流，进行了血管造影，结果显示侧支循环保留了右臂血流（箭头，图 2）。对慢性完全闭塞的右侧头臂静脉进行再通，并植入支架（图3）（2）。由于中心静脉阻塞的风险，应避免不必要地使用隧道式血液透析导管，并且 AVG 放置前的血管造影有助于设计对侧手臂的 AVG。
An 81-year-old woman on hemodialysis was admitted for right forearm arteriovenous graft (AVG) thrombosis. One year before admission, a tunneled hemodialysis catheter had been placed in the right jugular internal vein. This catheter had been removed and an AVG created six months before admission. Computed tomography revealed occlusion of the right brachiocephalic vein and jugular internal vein (asterisk and arrow, Picture 1). These occlusions were considered to have been caused by the tunneled hemodialysis catheter (1). To restore the AVG blood flow, angiography was performed, which revealed collateral circulation that preserved the right arm blood flow (arrow, Picture 2). The chronic total occlusion of the right brachiocephalic vein was recanalized, and a stent was implanted (Picture 3) (2). The unnecessary use of a tunneled hemodialysis catheter should be avoided due to risks of central venous occlusion, and angiography before AVG placement is helpful for designing AVGs in the opposite arm.