Catheterization via direct cannulation of superior vena cava for a hemodialysis patient with an original dysfunctional catheter on the left internal jugular vein
	    		
		   		
		   			
		   		
	    	
    	 
    	10.1007/s11684-017-0520-0
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Zhou LI
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Chen LIN
			        		
			        		;
		        		
		        		
		        		
			        		Yu YANG
			        		
			        		;
		        		
		        		
		        		
			        		Cui TIANLEI
			        		
			        		;
		        		
		        		
		        		
			        		Li XIAO
			        		
			        		;
		        		
		        		
		        		
			        		Fu PING
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Division of Nephrology
			        		
		        		
	        		
        		 
        	
        	
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		superior vena cava;
			        		
			        		
			        		
				        		intervention;
			        		
			        		
			        		
				        		vascular access exhaustion;
			        		
			        		
			        		
				        		catheterization;
			        		
			        		
			        		
				        		tunneled cuffed hemodialysis catheter
			        		
			        		
	        			
        			
        		
 
        	
            
            
            	- From:
	            		
	            			Frontiers of Medicine
	            		
	            		 2017;11(3):445-448
	            	
            	
 
            
            
            	- CountryChina
 
            
            
            	- Language:Chinese
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	Establishing a long-term vascular access in patients exhibiting vascular access exhaustion is challenging.In this study,we reported a case of a direct catheterization in the superior vena cava of a hemodialysis patient with vascular access exhaustion and original dysfunctional catheter inserted via the left internal jugular vein.The direct catheterization was performed with cuffed tunnel catheter (CUFF) and guided by digital subtraction angiography (DSA) and multidetector computedtomography venography (MDCTV).The DSA and MDCTV results revealed an occlusion in the right innominate vein and thromboses in the left innominate,right internal jugular,subclavian,and femoral veins.The distal end of the superior vena cava was localized clearly by the original CUFF under DSA.Directed at the distal end of the superior vena cava,a 0.5-cm secondary puncture was introduced below the lateral head of the sternocleidomastoid muscle via the right neck area.This study is one of the few reports regarding direct catheterization of CUFF via the superior vena cava of a patient with vascular access exhaustion and CUFF dysfunction on the left internal jugular vein.We believe that our study can provide a new alternative for inserting central venous catheter for such patient.