ABSTRACT
@#Central venous stenosis is a common complication following long-term dialysis catheter placement in dialysis patients. Generally, percutaneous angioplasty is the treatment of choice, and venous stent implantation should be considered in different situations. However, the venous stent migrating into right atrium is a rare but fatal complication. We presented a patient whose superior vena cava stents migrated into right atrium, resulting in acute tamponade, and exploratory thoracotomy was proceeded.
ABSTRACT
Objective To explore the efficacy of interventional therapy for central venous stenosis in maintenance hemodialysis patients. Methods The general clinical data of the maintenance hemodialysis patients with central venous stenosis, who received interventional therapy in Changzheng Hospital of Naval Medical University (Second Military Medical University) from Jan. 2014 to Mar. 2018, were retrospectively analyzed, and the patency of vascular access of interventional therapy were followed up. Results A total of 82 maintenance hemodialysis patients with central venous stenosis were enrolled. Six-eight patients (82.93%) had a history of temporary central venous catheterization. Among the 82 patients, 13 (15.85%) had double lesions of central vein and 69 (84.15%) had single lesion; and 5 (6.10%) had mild lesions, 17 (20.73%) had moderate lesions, 35 (42.68%) had severe lesions and 25 (30.49%) had complete occlusion. Of the 82 patients, 57 were treated by percutaneous transluminal angioplasty and 9 by percutaneous transluminal stenting. The follow-up period ranged from 12 to 62 months after operation. The patency rate of vascular access was 75.76% (50/66) at 6 months postoperatively and 68.18% (45/66) at 12 months postoperatively. The overall patency rate of vascular access was 59.09% (39/66). Conclusion Central venous stenosis of the maintenance hemodialysis patients can affect the life of vascular access. For the patients with symptoms that can not be alleviated, active intervention is recommended. Intervention therapy is safe and effective for the patients with central venous stenosis. Meanwhile, the central venous catheterization shall be avoided if possible to reduce central venous stenosis in the patients with chronic kidney disease.
ABSTRACT
El síndrome de la bolsa de orina púrpura es una condición muy poco frecuente, caracterizada por una llamativa coloración púrpura intensa de la orina. Se observa en pacientes con cateterización de la vía urinaria y la infección por determinadas bacterias capaces de generar una reacción química entre la orina y el material plástico de la bolsa colectora, que resulta en un llamativo color púrpura en la orina. Presentamos un caso de PUBS por ser un fenómeno poco frecuente, por la preocupación que genera en el enfermo y en el equipo de salud, y por las implicancias clínicas del manejo de las infecciones del tracto urinario
Purple urine bag syndrome is a rare condition, characterized by purple coloration of the urine inside the bag. It is observed in patients who have urinary catheters together with an infection associated with certain bacterial species, which produce a chemical reaction between the plastic of the urine bag and the urine, resulting in an intense purple color of the urine. We report a patient with PUBS, because it is an unfrequented phenomenon that generates alarm in family members and health care workers and because of the clinical implications of urinary tract infection management
Subject(s)
Humans , Urinary Tract Infections , Catheterization , Renal DialysisABSTRACT
Central venous catheters are the most frequent causes of benign central vein stenosis. We report the case of a 79-year-old woman on hemodialysis through a twin catheter in the right internal jugular vein, presenting with superior vena cava (SVC) syndrome with patent SVC. The clinically driven endovascular therapy was conducted to treat the venous syndrome with a unilateral left brachiocephalic stent-graft without manipulation of the well-functioning catheter. The follow-up was uneventful until death 94 months later.
Subject(s)
Aged , Female , Humans , Brachiocephalic Veins , Central Venous Catheters/adverse effects , Constriction, Pathologic/etiology , Jugular Veins , Renal Dialysis/instrumentation , Stents , Superior Vena Cava Syndrome/etiology , Vena Cava, SuperiorABSTRACT
Stenting of the central veins is well established for treating localized venous stenosis. The techniques regarding catheter preservation for central venous catheters in the superior vena cava have been described. We describe here a method for stent implantation in the superior vena cava and the left brachiocephalic vein, and principally via a single jugular venous puncture, while saving a left sided jugular central venous catheter in a patient suffering from central venous stenosis of the superior vena cava and the left brachiocephalic vein.