Endovascular port-a-cath rescue in acute thrombotic superior vena cava syndrome

AbstractAcute superior vena cava (SVC) syndrome is managed by endovascular recanalization, venoplasty with stenting, and anticoagulation. It is often associated with central venous catheters. We present a case of a 55-year-old woman with acute SVC syndrome due to port-a-cath-associated thrombosis of...

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Bibliographic Details
Published in:Journal of vascular surgery cases and innovative techniques 2019-06, Vol.5 (2), p.169-173
Main Authors: Amberger, Hanno, MD, Baumgartner, Iris, MD, Kucher, Nils, MD, Schindewolf, Marc, MD
Format: Article
Language:English
Subjects:
Catheter-directed thrombolysis
Port-a-cath snaring
Port-a-cath-associated thrombosis
Superior vena cava syndrome
Surgery
Upper extremity venous thrombosis
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Summary:AbstractAcute superior vena cava (SVC) syndrome is managed by endovascular recanalization, venoplasty with stenting, and anticoagulation. It is often associated with central venous catheters. We present a case of a 55-year-old woman with acute SVC syndrome due to port-a-cath-associated thrombosis of the SVC and the brachiocephalic and subclavian veins who was treated with catheter-based thrombectomy and local spray thrombolysis, venoplasty, and stent placement. Port-a-cath restoration was achieved in the same session by endovascular snaring and repositioning. This case demonstrates that reoperation with surgical catheter removal and reinsertion of central venous catheters with possible complications (eg, rethrombosis, bleeding) can be avoided by single-session endovascular management.
ISSN:2468-4287
2468-4287
DOI:10.1016/j.jvscit.2019.03.005