title: Percutaneous replacement of a right jugular dialysis catheter via a stenosed superior vena cava.
abstract: A female patient with end-stage renal failure, who was maintained on haemodialysis via multiple central dialysis catheters, developed chronic occlusion of the left brachiocephalic vein. Subsequently, the right jugular dual lumen PermCath became dysfunctional because of marked superior vena cava stenosis. Angioplasty of the superior vena cava stenosis was performed but failed to restore adequate catheter function. The patient was referred for possible salvage of her central venous access and re-insertion of a new PermCath. During surgery, the right jugular PermCath was removed, the superior vena cava was stented to establish venous patency, and a new PermCath was re-inserted via the existing right jugular puncture site. The technique helps reduce cost and time, and avoids another jugular puncture. In addition, this procedure saves a central venous access which is important in patients on long-term haemodialysis.
authors.affiliation: Department of Radiology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong.
authors.forename: K Y
authors.initials: KY
authors.lastname: Lau
authors.forename: J K W
authors.initials: JK
authors.lastname: Chan
authors.forename: W W C
authors.initials: WW
authors.lastname: Wong
authors.forename: S H K
authors.initials: SH
authors.lastname: Lo
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon; D002405:Catheterization, Central Venous; D002408:Catheters, Indwelling / Q000009:adverse effects*; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D020878:Device Removal; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging; D007676:Kidney Failure, Chronic / Q000628:therapy*; D006435:Renal Dialysis / Q000295:instrumentation*; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000628:therapy*