Superior Vena Cava Thrombosis in A Young Hemodialysis Patient After 1 year of Central Venous Catheter Removal: A Case Report

Yıl 2024, Cilt: 15 Sayı: 1, 4 - 6, 29.03.2024

Osman Beydüz , Abdul Samet Şahin , Ragıp Kadı , Muhammet Fatih Beşer

https://doi.org/10.33706/jemcr.1389895

Öz

Introduction:
Superior vena cava (SVC) syndrome is a rare but serious condition resulting from obstruction of the superior vena cava or its tributaries. Although often associated with malignancy, it can also occur due to central venous catheterization(1). Acute SVC syndrome following catheter removal is uncommon.
Case Report:
We present a 35-year-old hemodialysis patient with a history of central venous catheterization for hemodialysis one year prior. During a routine hemodialysis session, the patient developed symptoms of shortness of breath, neck swelling, and cyanosis of the lips. Physical examination revealed neck edema and prominent superficial vascular bifurcations. Without imaging studies, it was confused with cellulitis, but CT angiography later confirmed SVC thrombosis. The patient was started on anticoagulation and transferred to a tertiary hospital for further management.
Conclusion:
Emergency physicians should be aware of SVC syndrome, especially in hemodialysis patients with a history of central venous catheterization. Although it is often associated with malignancy, this case highlights the importance of considering SVC thrombosis even after catheter removal. Prompt diagnosis and appropriate management are essential to prevent life-threatening complications. Therefore, recognition and inclusion of SVC syndrome in the differential diagnosis is essential for timely intervention and improved patient outcomes.

Anahtar Kelimeler

Thrombosis, central venous catheterization, SVC syndrome

Destekleyen Kurum

not supported by any institution

Kaynakça

• 1. Küçükarslan N, Yilmaz M, Us M, Arslan Y, Güler A, Yilmaz A (2007). Diyaliz kateterinin neden olduğu vena kava süperior sendromu: Olgu sunumu. Ulusal Travma ve Acil Cerrahi Dergisi, 13(1), 63 - 66.
• 2. Azizi, A. H., Shafi, I., Shah, N., Rosenfield, K., Schainfeld, R., Sista, A., & Bashir, R. (2020). Superior Vena Cava Syndrome. JACC. Cardiovascular interventions, 13(24), 2896–2910. https://doi.org/10.1016/j.jcin.2020.08.038
• 3. Labriola, L., Seront, B., Crott, R., Borceux, P., Hammer, F., & Jadoul, M. (2018). Superior vena cava stenosis in haemodialysis patients with a tunnelled cuffed catheter: prevalence and risk factors. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 33(12), 2227–2233. https://doi.org/10.1093/ndt/gfy150
• 4. Arasu, M., Thangaswamy, C. R., Chakravarthy, D., & Elakkumanan, L. B. (2021). Catheter-related superior vena cava thrombosis-how do we face it?. Annals of cardiac anaesthesia, 24(4), 512–514. https://doi.org/10.4103/aca.ACA_119_20
• 5. Janssen M, Logtenberg S. (2022). Vena Cava Superior Syndrome Six Years after Central Venous Catheter Removal in a Patient on Hemodialysis. Case Rep Nephrol Dial, 12(2):132-137. doi:10.1159/000525795
• 6. Thapa, S., Terry, P. B., & Kamdar, B. B. (2016). Hemodialysis catheter-associated superior vena cava syndrome and pulmonary embolism: a case report and review of the literature. BMC research notes, 9, 233. https://doi.org/10.1186/s13104-016-2043-1
• 7. Shaikh, I., Berg, K., & Kman, N. (2013). Thrombogenic catheter-associated superior vena cava syndrome. Case reports in emergency medicine, 2013, 793054. https://doi.org/10.1155/2013/793054
• 8. Adışen E, Özer İ, Gürer MA. (2016). Vena Kava Süperior Sendromu. Dermatoz, 7(2):0-0 . doi: 10.15624.dermatoz16072o5
• 9. Cui, J., Kawai, T., & Irani, Z. (2015). Catheter-directed Thrombolysis in Acute Superior Vena Cava Syndrome Caused by Central Venous Catheters. Seminars in dialysis, 28(5), 548–551. https://doi.org/10.1111/sdi.12362