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Misplaced tunneled catheter into azygos vein.

Sampathkumar K, Prabhakar A, Saravanan R, Nayak MA - Indian J Nephrol (2015 Nov-Dec)

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Meenakshi Mission Hospital and Research Centre, Madurai, Tamil Nadu, India.

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Tunneled cuffed internal jugular vein catheters (TCC) are frequently used for hemodialysis... Under local anesthesia with aseptic precautions, a TCC was introduced into right internal jugular vein by anatomical landmark guidance... A check chest X-ray revealed that the tip of the TCC was unusually curved [Figure 1]... It showed that the catheter tip was in the azygos vein at the posterior mediastinum [Figure 2]... The TCC was pulled up into superior vena cava (SVC)... A guidewire was inserted through the catheter... After confirming the position of the guidewire in the inferior vena cava, TCC was positioned at mid right atrium [Figure 3]... Azygos vein courses in the posterior mediastinum from abdomen to empty into SVC with wide variation in its anatomical position, tributaries, and course... The size of its opening into SVC can vary between of 4 and 16 mm... This may permit the tip of TCC to enter the vein... Lateral chest X-ray will reveal the catheter to be placed in the posterior mediastinum... Serious hemorrhage and hemothorax have been encountered due to such misplacement... Use of fluoroscopy could have prevented this occurrence.

No MeSH data available.


Lateral fluoroscopic view. Black arrow shows tunneled cuffed catheter in posterior mediastinum. White arrow shows dye entering Azygos vein
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Figure 2: Lateral fluoroscopic view. Black arrow shows tunneled cuffed catheter in posterior mediastinum. White arrow shows dye entering Azygos vein

Mentions: A 36-year-old man was initiated on maintenance HD. Under local anesthesia with aseptic precautions, a TCC was introduced into right internal jugular vein by anatomical landmark guidance. A check chest X-ray revealed that the tip of the TCC was unusually curved [Figure 1]. In a fluoroscopy suite, contrast was injected into the venous limb of the TCC. It showed that the catheter tip was in the azygos vein at the posterior mediastinum [Figure 2]. The TCC was pulled up into superior vena cava (SVC). A guidewire was inserted through the catheter. After confirming the position of the guidewire in the inferior vena cava, TCC was positioned at mid right atrium [Figure 3]. Adequate blood flow could be achieved for HD.


Misplaced tunneled catheter into azygos vein.

Sampathkumar K, Prabhakar A, Saravanan R, Nayak MA - Indian J Nephrol (2015 Nov-Dec)

Lateral fluoroscopic view. Black arrow shows tunneled cuffed catheter in posterior mediastinum. White arrow shows dye entering Azygos vein
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663781&req=5

Figure 2: Lateral fluoroscopic view. Black arrow shows tunneled cuffed catheter in posterior mediastinum. White arrow shows dye entering Azygos vein
Mentions: A 36-year-old man was initiated on maintenance HD. Under local anesthesia with aseptic precautions, a TCC was introduced into right internal jugular vein by anatomical landmark guidance. A check chest X-ray revealed that the tip of the TCC was unusually curved [Figure 1]. In a fluoroscopy suite, contrast was injected into the venous limb of the TCC. It showed that the catheter tip was in the azygos vein at the posterior mediastinum [Figure 2]. The TCC was pulled up into superior vena cava (SVC). A guidewire was inserted through the catheter. After confirming the position of the guidewire in the inferior vena cava, TCC was positioned at mid right atrium [Figure 3]. Adequate blood flow could be achieved for HD.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Meenakshi Mission Hospital and Research Centre, Madurai, Tamil Nadu, India.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Tunneled cuffed internal jugular vein catheters (TCC) are frequently used for hemodialysis... Under local anesthesia with aseptic precautions, a TCC was introduced into right internal jugular vein by anatomical landmark guidance... A check chest X-ray revealed that the tip of the TCC was unusually curved [Figure 1]... It showed that the catheter tip was in the azygos vein at the posterior mediastinum [Figure 2]... The TCC was pulled up into superior vena cava (SVC)... A guidewire was inserted through the catheter... After confirming the position of the guidewire in the inferior vena cava, TCC was positioned at mid right atrium [Figure 3]... Azygos vein courses in the posterior mediastinum from abdomen to empty into SVC with wide variation in its anatomical position, tributaries, and course... The size of its opening into SVC can vary between of 4 and 16 mm... This may permit the tip of TCC to enter the vein... Lateral chest X-ray will reveal the catheter to be placed in the posterior mediastinum... Serious hemorrhage and hemothorax have been encountered due to such misplacement... Use of fluoroscopy could have prevented this occurrence.

No MeSH data available.