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

• Autor(a) principal: Afonso,Nuno
• Data de Publicação: 2020
• Outros Autores: Rodrigues,Luís, Ferreira,Emanuel, Pinto,Helena, Nogueira,Rui, Anacleto,Gabriel, Fonseca,Manuel, Alves,Rui
• Tipo de documento: Relatório
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692020000300007
• topic: Central Venous Occlusion; Central Veins; Surfacer

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.