title: Endovascular port-a-cath insertion in a patient with cystic fibrosis and occluded superior vena cava.
abstract: BACKGROUND
  Port-a-cath insertion, for long-term intravenous antibiotic therapy, is an ideal solution for patient with cystic fibrosis. However, indwelling lines are liable to many complications including catheter thrombosis especially in patients having cystic fibrosis with hypercoagulable state.
  
  
  METHODS
  An endovascular technique for insertion of a port-a-cath in a patient having cystic fibrosis with occluded superior vena cava is reported. The technique is described in detail. In addition, a review of literature for the various methods of saving a failed central venous access in these patients was performed.
  
  
  RESULTS
  The line was successfully inserted and remained patent without need of any further intervention for 20 months.
  
  
  CONCLUSIONS
  In this report, several endovascular skills were used for central venous access salvage that can be used in similar situations with chronic superior vena cava occlusion, which may not be suitable for thrombolysis or stenting.
authors.affiliation: Department of Vascular Surgery, King's College Hospital, Denmark Hill, London, United Kingdom.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ali
authors.forename: Hany
authors.initials: H
authors.lastname: Zayed
authors.forename: Jason
authors.initials: J
authors.lastname: Wilkins
authors.forename: Hilary
authors.initials: H
authors.lastname: Wyatt
authors.forename: Hisham
authors.initials: H
authors.lastname: Rashid
mesh_terms: D000800:Angioplasty, Balloon / Q000295:instrumentation; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002408:Catheters, Indwelling; D003550:Cystic Fibrosis / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D011859:Radiography; D013479:Superior Vena Cava Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D018084:Ultrasonography, Interventional; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents