title: A Case Report of a Direct Catheterization of Tunneled Cuffed Catheter via Superior Vena Cava: A Choice after Vascular Access Exhaustion.
abstract: OBJECTIVE
  To establish a new way for long-term vascular access for dialysis patient with vascular access exhaustion.
  
  
  METHODS
  A patient with diabetes was found with edema of right arm and high venous pressure of AVF during hemodialysis. Intervention operations were performed to establish a tunneled cuffed catheterization.
  
  
  RESULTS
  Occlusion of innominate vein was confirmed by MDCTV. Puncture to superior vena cava was successful 0.5 cm below the lateral head of sternocleidomastoid muscle directly via the right neck area.
  
  
  CONCLUSIONS
  Direct puncture via superior vena cava might be the last choice for catheter insertion site. choice for catheter insertion site.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Tianlei
authors.initials: T
authors.lastname: Cui
authors.forename: Qiuyan
authors.initials: Q
authors.lastname: Zhao
authors.forename: Li
authors.initials: L
authors.lastname: Zhou
authors.forename: Xiao
authors.initials: X
authors.lastname: Li
authors.forename: Ping
authors.initials: P
authors.lastname: Fu
mesh_terms: D000368:Aged; D000792:Angiography; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology; D002408:Catheters, Indwelling; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy; D008297:Male; D006435:Renal Dialysis / Q000379:methods; D014683:Vena Cava, Superior