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Rescuing the nephrologist's main central vein – placement of a right jugular vein catheter in a patient with thoracic central venous occlusion by use of the Surfacer® device

Nuno Afonso, Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Luís Rodrigues, Emanuel Ferreira, Helena Pinto, Rui Nogueira, Gabriel Anacleto, Manuel Fonseca, Rui Alves, Clínica Universitária de Nefrologia, Faculdade de Medicina da Universidade de Coimbra, Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Clínica Universitária de Nefrologia, Faculdade de Medicina da Universidade de Coimbra (+9 others)
2020 Portuguese Journal of Nephrology and Hypertension  

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Central venous stenosis can be the main obstacle to the creation of a vascular access. The Surfacer® device was developed to solve the problem of complete occlusions of the right internal jugular vein, right brachiocephalic vein and superior vena cava, allowing for the placement of a vascular access in this venous axis. Case Report: We present the case of a 77 -year -old patient on long -term hemodialysis with a long history of failed vascular accesses and of central vein stenosis, chronically
more » ... ialyzed using a tunneled catheter placed through the left femoral vein. With use of the Surfacer® device it was possible to recreate, with an inside -out technique, a tract through the fibrous tissue of the completely occluded right brachiocephalic and right internal jugular veins, subsequently placing a tunneled catheter into the right atrium through this later vein. Conclusion: We report the first successful use in Portugal of a new vascular access device that allows us to rescue a previous unusable right central venous axis for the placement of a central venous catheter, thus avoiding the use of less advantageous options such as the femoral veins and preserving venous vascular capital.
doi:10.32932/pjnh.2020.10.088 fatcat:allrmslrerdc3gnnlhnbm45aei
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Nuno Afonso, Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Luís Rodrigues, Emanuel Ferreira, Helena Pinto, Rui Nogueira, Gabriel Anacleto, Manuel Fonseca, Rui Alves, Clínica Universitária de Nefrologia, Faculdade de Medicina da Universidade de Coimbra, Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Clínica Universitária de Nefrologia, Faculdade de Medicina da Universidade de Coimbra, Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Clínica Universitária de Nefrologia, Faculdade de Medicina da Universidade de Coimbra, Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Clínica Universitária de Nefrologia, Faculdade de Medicina da Universidade de Coimbra, Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Serviço de Cirurgia Vascular, Centro Hospitalar e Universitário de Coimbra, Serviço de Cirurgia Vascular, Centro Hospitalar e Universitário de Coimbra, Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Clínica Universitária de Nefrologia, Faculdade de Medicina da Universidade de Coimbra. "Rescuing the nephrologist's main central vein – placement of a right jugular vein catheter in a patient with thoracic central venous occlusion by use of the Surfacer® device." Portuguese Journal of Nephrology and Hypertension 35.3 (2020)