title: Catheter-directed Thrombolysis in Acute Superior Vena Cava Syndrome Caused by Central Venous Catheters.
abstract: Indwelling central venous catheters have been reported to increase the risk of superior venous cava (SVC) syndrome. This case report describes the development of acute SVC syndrome in a 28-year-old woman with end-stage renal disease implanted with a left-side hemodialysis reliable outflow graft and a right-side double lumen hemodialysis catheter via internal jugular veins. Her symptoms were not alleviated after catheter removal and systemic anticoagulation therapy. She was eventually treated with catheter-directed thrombolysis and a predischarge computer tomographic venogram on postthrombolytic procedure day 7 showed patent central veins and patient remained asymptomatic. This case demonstrates that catheter-directed thrombolysis can be safely employed to treat refractory catheter-induced acute SVC syndrome in end-stage renal disease patients.
authors.affiliation: Nephrology Division, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Jie
authors.initials: J
authors.lastname: Cui
authors.affiliation: Division of Transplant Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Tasuo
authors.initials: T
authors.lastname: Kawai
authors.affiliation: Division of Vascular Imaging and Intervention, Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Zubin
authors.initials: Z
authors.lastname: Irani
mesh_terms: D000328:Adult; D002408:Catheters, Indwelling / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects*; D020878:Device Removal; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D010690:Phlebography; D006435:Renal Dialysis / Q000009:adverse effects*; D013479:Superior Vena Cava Syndrome / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods*
chemical_list: D005343:Fibrinolytic Agents