Abstract

AFONSO, Nuno et al. 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. Port J Nephrol Hypert [online]. 2020, vol.34, n.3, pp.165-169. ISSN 0872-0169.  https://doi.org/10.32932/pjnh.2020.10.088.

Introduction: 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 dialyzed 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.

Keywords : Central Venous Occlusion; Central Veins; Surfacer.

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