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Persistent left superior vena cava and partially left inferior vena cava: a case report of a dangerous central venous catheterization

Abstract

Background

The coexistence of a double superior vena cava (SVC) and a partially left inferior vena cava (PLIVC) with a circumaortic collar, associated with other congenital malformations, was not described previously.

Case description

We present a 33-year-old woman in hemodialysis with complete exhaustion of the brachial routes for vascular access, admitted to our Nephrology Unit for a long-term central venous catheter (CVC) implant, usually by us performed under EchoScopic Technique (EST), an echographic venipuncture followed by continuous radioscopic control of guidewire and catheter in all the steps of implant. An intraoperative venography showed a complete stop of right internal jugular vein, a right SVC, a persistent left SVC, a left inferior vena cava in the iliac and subrenal tracts, a circumaortic venous collar in the renal tract, and normal right suprarenal and hepatic tracts.

Conclusions

The double SVC was related to the persistence of the caudal part of the anterior cardinal veins. As to the PLIVC, the iliac and subrenal parts of the inferior vena cava can be related to the persistent left supracardinal vein, while the circumaortic venous collar to the persistent intersupracardinal and left subsupracardinal anastomoses. All invasive procedures, and particularly those potentially complicated, must be performed under EST, now considered a mandatory tool for CVC implants, owing to the hypothesis of possible venous congenital anomalies.

J Vasc Access 2017; 18(5): e66 - e69

Article Type: CASE REPORT

DOI:10.5301/jva.5000722

Authors

Biagio Ricciardi, Carlo Alberto Ricciardi, Antonio Lacquaniti, Giuseppe Carella, Domenico Puzzolo, Antonina Pisani, Debora Di Mauro, Antonio Micali

Article History

Disclosures

Informed consent: Written informed consent was obtained from the patient for publication of this Case report.
Financial support: No grants or funding have been received for this study.
Conflict of interest: None of the authors has financial interest related to this study to disclose.

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Authors

Affiliations

  • Nephrology Unit, Fogliani Hospital, Milazzo, Messina - Italy
  • Department of Clinical and Experimental Medicine, University of Messina, Messina - Italy
  • Radiology Unit, Barone Romeo Hospital, Patti, Messina - Italy
  • Department of Biomedical Sciences, University of Messina, Messina - Italy

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