Pacemaker Wire Central Venous Stenosis and One More Reason to Not Run Central Venous Catheters for Dialysis in Reverse Flow
Article first published online: 1 AUG 2012
© 2012 Wiley Periodicals, Inc.
Seminars in Dialysis
Volume 26, Issue 1, pages E1–E4, January/February 2013
How to Cite
Ash, S. R. and Ugianskis, E. J. (2013), Pacemaker Wire Central Venous Stenosis and One More Reason to Not Run Central Venous Catheters for Dialysis in Reverse Flow. Seminars in Dialysis, 26: E1–E4. doi: 10.1111/j.1525-139X.2012.01114.x
- Issue published online: 24 JAN 2013
- Article first published online: 1 AUG 2012
A 75-year-old man on chronic peritoneal dialysis had unrecognized stenosis of the superior vena cava (SVC) due to pacemaker wires placed 5 years earlier. The patient was placed on hemodialysis after hernia surgery. When a tunneled central venous catheter for dialysis was placed from the right internal jugular (IJ) vein, the venous lumen extended through the stenotic area but not the arterial lumen. Probably due to a subsequent clot at the arterial lumen port the patient developed SVC syndrome and when the catheter was run in the reversed flow direction he developed hypovolemic shock. The stenosis and SVC syndrome resolved with angioplasty of the SVC stenosis, removal of the IJ catheter and use of a femoral vein catheter. The patient eventually returned to peritoneal dialysis and the femoral catheter was removed.