Persistence of left superior vena cava: a rare cause of hemodialysis tunneled catheter malposition

Abstract Hemodialysis central venous catheter (CVC) insertion can be complicated in patients with anomalous vessel anatomy. In such cases detailed knowledge of thoracic vessel anatomy is necessary to identify the exact location of the catheter. Central venous placement under ultrasound control has significantly reduced the complications associated with blind puncture and allows an appropriate puncture of the desired vessel, but the CVC can still get misplaced if it follows an anomalous route. Herein, we report a case of dialysis catheter placed into a left sided superior vena cava, only diagnosed after CT scan study.

摘要：血液透析中心静脉导管（CVC）置入术在血管解剖异常患者中易引发并发症。此类病例中，需详细掌握胸腔血管解剖结构，以精准定位导管位置。超声引导下的中心静脉置管术已大幅降低盲穿相关并发症的发生风险，可实现目标血管的精准穿刺，但倘若导管走行存在异常路径，仍可能出现导管异位。本文报告1例透析导管置入左侧上腔静脉（left-sided superior vena cava）的病例，该异常直至CT扫描（CT scan）检查后才得以确诊。