case_images: PMC10185021_01
case_images: Schematic diagram showing trans lumbar dialysis catheter
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case_images: CT scan guidance [Figure 1]. Coagulation parameters (partial thromboplastin time, prothrombin time, and platelet count) were checked and corrected before procedure as necessary.
case_images: Coronal CT scan plain abdomen showing polycystic appearance involving both kidneys and liver
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case_images: Translumbar route was preferred over the transhepatic route in view of innumerable cysts within the liver parenchyma secondary to polycystic liver disease [Figure 2]. Translumbar dialysis catheter (TLDC) in our case was placed in an angiography suite by using fluoroscopic and Dyna Chiba needle 21-G, a 15-cm-long needle, was advanced under fluoroscopic and DynaCT guidance through subcutaneous tissues and back muscles (erector spinae and psoas) toward the inferior vena cava (IVC) [Figure 2].
case_images: Dyna CT scan plain abdomen showing the tip of Chiba needle within the IVC
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case_images: Once the needle entered the IVC, a guidewire was passed through it [Figure 3 and 4], and COOK percutaneous access set was used to secure the access.
case_images: AP and lateral fluoroscopy image showing the tip of Chiba needle at the level of L3 vertebral body with wire within the IVC
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case_images: Once the needle entered the IVC, a guidewire was passed through it [Figure 3 and 4], and COOK percutaneous access set was used to secure the access. Dacron cuff was tunneled under the skin and sutured [Figure 4 and Figure 5].
case_images: AP radiograph showing trans lumbar tunneled dialysis catheter with tip of the catheter at cavo-atrial junction
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case_images: Dacron cuff was tunneled under the skin and sutured [Figure 4 and Figure 5].
case_images: Post-procedure CT scan showing the course of translumbar dialysis catheter entry into psoas muscle and later into IVC
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case_images: DynaCT was performed for confirming the course of translumbar catheter [Figure 6].