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      Inserción accidental de catéter para hemodiálisis en vena cava superior izquierda persistente Translated title: Accidental implantation of hemodialysis catheter in persistent left superior vena cava

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          Abstract

          La implantación de catéteres centrales para hemodiálisis en pacientes con falla renal es una práctica común. El acceso venoso por punción percutánea de la vena yugular interna es la ruta más recomendada debido a que genera el menor porcentaje de estenosis. La punción de la vena yugular interna derecha es la más conveniente por su trayecto vertical hacia la aurícula derecha, pero en ocasiones su canalización es imposible siendo necesario puncionar la vena yugular interna izquierda, la cual se continúa con la vena innominada desembocando en la cava superior, de ahí que su trayecto sea muy tortuoso. Se describen tres casos en los cuales el catéter yugular interno izquierdo que se insertó para realizar hemodiálisis, accidentalmente canalizó la vena cava superior izquierda anormalmente persistente. En todos los casos y antes de proceder con la hemodiálisis se demostró bien sea por gases del vaso puncionado, ecocardiograma o medio de contraste que el catéter se encontraba posicionado en el sistema venoso que drena en la aurícula derecha.

          Translated abstract

          The implantation of central catheters for hemodialysis in patients with renal failure is a common practice. The venous access to the internal jugular vein through percutaneous puncture is the most recommended procedure because it produces the lowest percentage of stenosis. The right internal jugular vein puncture is the most appropriate one because it goes directly in vertical direction into the right atrium, but in some cases its canalization is impossible making it necessary to puncture the left internal jugular vein, the one next to the innominated vein that ends in the superior cava, with the result that its path is much curved. 3 cases in which the left intern jugular catheter that was inserted to perform hemodialysis accidentally canalized the anomaly in the persistent left superior vena cava were presented. In all the cases and before proceeding with the hemodialysis it was demonstrated by the gases of the punctuated vessel, echocardiogram or contrast medium that the catheter was positioned in the venous system that drains in the right atrium.

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          Most cited references 11

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          Persistent Left Superior Vena cava Detected by Hemodialysis Catheterization

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            Persistent left superior vena cava: diagnosis and implications for the interventional nephrologist.

            Awareness and recognition of anatomic anomalies of the great vessels of the neck and chest are important for the interventional nephrologist, as central venous catheter placement is a common procedure. A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly (0.3-0.5% of the population), and can present difficulty during internal jugular or subclavian vein catheter insertion, as well as pose a diagnostic dilemma. In this report, two cases of PLSVC are described, and the clinical significance and diagnosis of PLSVC are reviewed.
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              Unusual placement of a dialysis catheter: persistent left superior vena cava

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                amc
                Acta Medica Colombiana
                Acta Med Colomb
                Asociacion Colombiana de Medicina Interna (Bogotá )
                0120-2448
                December 2007
                : 32
                : 4
                : 227-230
                Affiliations
                [1 ] RTS Ltda. Sucursal Caldas Brazil
                [2 ] Universidades de Caldas
                Article
                S0120-24482007000400007
                Product
                Product Information: website
                Categories
                MEDICINE, GENERAL & INTERNAL

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