Accidental extravascular insertion of a subclavian hemodialysis catheter is signaled by nonvisualization of catheter tip.
Subclavian hemodialysis (HD) catheter placement under fluoroscopy with perforation of the superior vena cava (SVC) is a rare complication that needs to be recognized and treated appropriately. We report the case of a 47-year-old black woman under treatment for end-stage renal disease secondary to HIV-associated nephropathy who sustained an extravascular insertion of fluoroscopy-guided subclavian catheterization for HD. Subsequent successful removal of the extravascularly placed catheter along with repair of the lacerated SVC were effected by open thoracic surgery.
Florescu
Marius C
MC
Department of Medicine, Renal Diseases Division, SUNY Downstate Medical Center, Brooklyn, New York 11203, USA. florescudc@yahoo.com
Mousa
Albeir
A
Moussa
Hatem
H
Salifu
Moro
M
Friedman
Eli A
EA
D002404:Catheterization; D002405:Catheterization, Central Venous / Q000379:methods; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods; D013350:Subclavian Vein / Q000000981:diagnostic imaging; D019616:Thoracic Surgical Procedures / Q000379:methods; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*