Transhepatic guidance of translumbar hemodialysis catheter placement in the setting of chronic infrarenal IVC occlusion.
When patients with end-stage renal disease have exhausted both conventional and unconventional venous access options, creative solutions must be sought for hemodialysis catheter placement in order to ensure survival. This case describes a patient in urgent need of a dialysis catheter despite total occlusion of the jugular, subclavian, and femoral veins. Occlusion of the inferior vena cava (IVC) and right renal vein resulted in failed attempts at translumbar catheter placement. A gooseneck snare was temporarily advanced through the liver to the IVC for use as a fluoroscopic target to facilitate successful single-puncture, translumbar catheterization.
Lorenz
Jonathan M
JM
Department of Radiology, Section of Interventional Radiology, University of Chicago Hospitals, 5841 South Maryland Avenue, MC2026, Chicago, IL 60637, USA. jlorenz@radiology.bsd.uchicago.edu
Regalado
Sidney
S
Navuluri
Rakesh
R
Zangan
Steven
S
Vanha
Thuong
T
Funaki
Brian
B
D000368:Aged; D002405:Catheterization, Central Venous / Q000379:methods*; D002408:Catheters, Indwelling; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D015641:Radiography, Interventional; D006435:Renal Dialysis / Q000379:methods*; D018084:Ultrasonography, Interventional; D014682:Vena Cava, Inferior