case_images: PMC10990479_01
case_images: Preoperative, intraoperative, and postoperative catheter status of the first patient. a Angiography showed the position of long-term hemodialysis catheter in the left internal jugular vein before surgery (the end of the catheter was flush with the upper border of the 10th thoracic vertebra). b Angiography showed that the patient's superior vena cava had no obvious stenosis. c Intraductal balloon dilatation was performed to assist extubation under DSA. d, e Fibrin sheath was found around the catheter during thoracotomy. f X-ray showed the postoperative position of long-term hemodialysis catheter in the left internal jugular vein (the end of the catheter was located in the shadow of the right atrium, which was flush with the upper border of the 11th thoracic vertebra).
case_images: cnd-2024-0014-0001-537740_F01.jpg
case_images: PMC10990479_01_cnd-2024-0014-0001-537740_F01.jpg
case_images: F1
case_images: TC-CVC in the left internal jugular vein after the aforementioned dialysis access failed 6 years ago. The chest X-ray showed that the end of the catheter was level with the upper edge of the 10th thoracic vertebra (Fig. 1a). Extubation was unsuccessful, although intraductal balloon dilation was performed to help (Fig. 1c). After the brachiocephalic vein and the SVC are released, the cord-like sclerotic zone can be palpated in the SVC (Fig. 1d, e). The chest X-ray showed that the tip of the catheter was in the shadow of the right atrium, at the level of the upper edge of the 11th thoracic cone, and the mediastinum was not widened (Fig. 1f).
case_images: PMC10990479_02
case_images: Preoperative, intraoperative, and postoperative catheter status of the second patient. a Angiography showed the position of long-term hemodialysis catheter in the left internal jugular vein before surgery (the end of the catheter was flush with the level of the 7th thoracic vertebra). b Angiography showed that the patient's superior vena cava had no obvious stenosis. c Intraductal balloon dilatation was performed to assist extubation under DSA. d, e Fibrin sheath was found around the catheter during thoracotomy. f X-ray showed the postoperative position of long-term hemodialysis catheter in the left internal jugular vein (the end of the catheter was located in the shadow of the right atrium, which was flush with the upper border of the 10th thoracic vertebra).
case_images: cnd-2024-0014-0001-537740_F02.jpg
case_images: PMC10990479_02_cnd-2024-0014-0001-537740_F02.jpg
case_images: F2
case_images: The chest X-ray showed that the tip of the catheter was at the level of the 7th thoracic vertebra (Fig. 2a). The Doppler ultrasound showed poor vascular condition in both hands. Cavography of the superior vein showed no vascular stenosis (Fig. 2b). Extubation still failed, even though intraductal balloon dilation was performed (Fig. 2c).