Catheter-directed Thrombolysis in Acute Superior Vena Cava Syndrome Caused by Central Venous Catheters

Semin Dial. 2015 Sep-Oct;28(5):548-51. doi: 10.1111/sdi.12362. Epub 2015 Apr 1.

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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Catheters, Indwelling / adverse effects*
  • Central Venous Catheters / adverse effects*
  • Device Removal
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Kidney Failure, Chronic / therapy
  • Phlebography
  • Renal Dialysis / adverse effects*
  • Superior Vena Cava Syndrome / diagnosis
  • Superior Vena Cava Syndrome / etiology
  • Superior Vena Cava Syndrome / therapy*
  • Thrombolytic Therapy / methods*

Substances

  • Fibrinolytic Agents