Superior vena cava syndrome associated with central venous catheter insertion

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We present the first case of hyperacute SVC syndrome that developed within 6 hours of insertion of a CVC into a patient’s right internal jugular vein alongside a pre-existing right internal jugular tunnelled dialysis line. With removal of the line, the patient’s symptoms resolved completely within hours” Edginton and Fundytus (2019).

Abstract:

Superior vena cava (SVC) syndrome is classically thought of as a complication of malignancy. However, SVC syndrome secondary to indwelling central venous catheters (CVCs) is another important entity. Amongst those with CVCs who develop SVC syndrome, the majority are attributed to thrombosis. Aside from thrombosis, CVCs can lead to SVC syndrome secondary to mechanical obstruction of blood flow in an already narrowed vessel. We present the first case of hyperacute SVC syndrome that developed within 6 hours of insertion of a CVC into a patient’s right internal jugular vein alongside a pre-existing right internal jugular tunnelled dialysis line. With removal of the line, the patient’s symptoms resolved completely within hours. The patient also was found to have stenosis of superior vena cava, likely secondary to multiple instrumentations.Physicians must be diligent to monitor for this complication in patients who have had previous instrumentations of major vessels when inserting CVCs.

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Reference:

Edginton, S. and Fundytus, A. (2019) Hyperacute Superior Vena Cava Syndrome associated with Central Venous Catheter Insertion. Indian Journal of Critical Care Medicine. 23(3), p.152-154. doi: 10.5005/jp-journals-10071-23140.

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