A Case of Central Vein Stenosis Complicated by Calcified Lesions of Pulmonary Tuberculosis / 대한신장학회지

ABSTRACT

Central venous stenosis or occlusion is commonly associated with placement of central venous catheters or devices. Although rare, central venous stenosis or occlusion may also develop without a history of previous central venous catheter placement. Here we report a case of central venous stenosis without a previous central catheter placement. A 76-year-old woman with hypertensive nephropathy was admitted due to deterioration of renal function. Tunneled cuffed catheter for hemodialysis was inserted in the right external jugular vein, and we intended to insert central venous catheter because of poorly functioning peripheral vein. But, left internal jugular vein was not cannulated. The patients had a history of pulmonary tuberculosis and chest x-ray revealed extensive calcified lesions mainly in left upper lung. Venography and CT angiogram showed complete occlusion at the confluent point of the left subclavian vein and left internal jugular vein, and left brachiocephalic vein by calcified lesion. The anterior cervical vein and jugular venous arch forming an anastomosis between the neck vein were marked dilated. The patient did not show any clinical symptoms and signs associated with central venous stenosis, and the central venous catheter functioned well, correction of central vein stenosis was not necessary. After the supportive care including temporary hemodialysis, the patient improved from renal dysfunction.