An unusual case of iatrogenic central venous injury.

Autor: Singh V; Department of Nephrology, Army Hospital (Research & Referral), Delhi Cantt, Delhi, India., Dabas AK; Department of Vascular Surgery, Army Hospital (Research & Referral), Delhi Cantt, Delhi, India., Singh P; MS Ramaiah Medical College, Bangalore, India., S S; Department of Nephrology, Army Hospital (Research & Referral), Delhi Cantt, Delhi, India., Dogra PM; Department of Nephrology, Army Hospital (Research & Referral), Delhi Cantt, Delhi, India., Ghosh I; Department of Nephrology, Army Hospital (Research & Referral), Delhi Cantt, Delhi, India.
Jazyk: angličtina
Zdroj: Seminars in dialysis [Semin Dial] 2024 Jan-Feb; Vol. 37 (1), pp. 79-82. Date of Electronic Publication: 2023 Nov 15.
DOI: 10.1111/sdi.13186
Abstrakt: Central venous catheter (CVC) provides ready vascular access and is widely used for the performance of hemodialysis. The use of CVC is associated with many complications and one life-threatening complication is central venous injury. We describe an unusual case of central venous injury in a 69-year-old lady with a poorly functioning left internal jugular vein catheter, which was in situ at the time of attempting insertion of a replacement right internal jugular catheter. The management included initial stabilization, urgent hemodialysis, imaging, and an endovascular approach to mitigate the iatrogenic venous injury. The case highlights many learning points. The operator needs to be vigilant for anatomical abnormalities like stenosis in patients who have had previous CVC. In those with central venous perforation, the CVC should be left in situ till a definitive management plan is formulated. An endovascular approach, when feasible, is a minimally invasive effective management strategy.
(© 2023 Wiley Periodicals LLC.)
Databáze: MEDLINE
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