Hemodialysis catheter-associated superior vena cava syndrome and pulmonary embolism: A case report and review of the literature

Sritika Thapa, Peter Browne Terry, Biren B. Kamdar

Research output: Contribution to journalArticle

Abstract

Background: Hemodialysis (HD) catheters are frequently inserted into the superior vena cava (SVC), and can lead to thrombotic complications. However, to our knowledge, HD catheter-related thrombosis leading to subsequent SVC syndrome, bacteremia, and pulmonary emboli has not been described. Case presentation: A 28-year-old dialysis-dependent woman with IgA nephropathy developed facial swelling, head pressure, headache, nausea, dizziness and fever 6 weeks after right internal jugular (IJ) HD catheter placement. Chest and neck imaging demonstrated a non-occlusive thrombus surrounding the HD catheter and extending from the SVC to the junction of the right IJ and right subclavian veins, confirming thrombosis-associated SVC syndrome. Intravenous (IV) anticoagulation was initiated, as well as IV vancomycin for Staphylococcus epidermidis bacteremia. Despite prompt intravenous anticoagulation, 9 and 12 days after initial presentation she developed catheter-associated pulmonary embolism (PE) and PE-associated pulmonary infarction, respectively. Hypercoagulable workup was negative. The HD catheter was eventually replaced, HD resumed, and the patient was transitioned from intravenous to oral anticoagulation and discharged. Nine months later, she underwent successful renal transplantation. Conclusion: SVC syndrome and pulmonary embolism are potential consequences of HD catheter-related thrombosis. Given the frequency of HD catheter placement, physicians should be aware of these potential complications in any patient with HD catheter-related thrombosis.

Original languageEnglish (US)
Article number233
JournalBMC Research Notes
Volume9
Issue number1
DOIs
StatePublished - 2016

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Superior Vena Cava Syndrome
Catheters
Pulmonary Embolism
Renal Dialysis
Thrombosis
Superior Vena Cava
Neck
Bacteremia
Pulmonary Infarction
Subclavian Vein
Staphylococcus epidermidis
Dialysis
Dizziness
Vancomycin
Embolism
Kidney Transplantation
Immunoglobulin A
Nausea
Headache
Swelling

Keywords

  • Catheter
  • Hemodialysis
  • Pulmonary embolism
  • Superior vena cava syndrome
  • Thrombosis

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Hemodialysis catheter-associated superior vena cava syndrome and pulmonary embolism : A case report and review of the literature. / Thapa, Sritika; Terry, Peter Browne; Kamdar, Biren B.

In: BMC Research Notes, Vol. 9, No. 1, 233, 2016.

Research output: Contribution to journalArticle

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