title: Transhepatic guidance of translumbar hemodialysis catheter placement in the setting of chronic infrarenal IVC occlusion.
abstract: 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.
authors.affiliation: 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
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Lorenz
authors.forename: Sidney
authors.initials: S
authors.lastname: Regalado
authors.forename: Rakesh
authors.initials: R
authors.lastname: Navuluri
authors.forename: Steven
authors.initials: S
authors.lastname: Zangan
authors.forename: Thuong
authors.initials: T
authors.lastname: Vanha
authors.forename: Brian
authors.initials: B
authors.lastname: Funaki
mesh_terms: 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