Thoracic Central Venous Occlusion in Patients Without
History of Central Vein Catheterization
Thanu K, MD¹, Srisuwan T, MD², Kulprachakarn K, PhD³, Pongtam S, MS³, Saengyo S, BS³, Rerkasem K, MD, PhD¹ , ³
Affiliation : ¹ Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand ² Interventional Radiology Unit, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand ³ NCD Research Unit, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
Background: Thoracic central vein occlusion (TCVO) was a common problem in hemodialysis dependent patients. The major
cause of TCVO is due to hemodialysis catheter, but the data of TCVO in patients without any history of previous catheterization
in Asia is very limited.
Materials and Methods: The authors collected data from computed tomographic venography (CTV) between January 2010 and December 2012. Patients that had clinical TCVO performed CTV were included consecutively. Baseline clinical data, the history of hemodialysis catheter placement, and CTV findings were recorded and analyzed.
Results: Seventy-six patients were enrolled in the present study. Patient with previous hemodialysis catheterization in central vein had statistically significant higher incidence of TCVO (6.93 times) than those without history of hemodialysis catheter placement (p<0.0001). Twenty-two TCVO were found in the vein, which had hemodialysis catheter placed previously. In this group, CTV reveal external compression by aortic branch or aortic dissection in six patients.
Conclusion: History of central venous cannulation was strongly associated with TCVO. However, TCVO could be found in patients who did not have a history of central vein catheterization. The external compression by aortic branch and dissection was also a cause of TCVO.
Keywords : Thoracic central venous occlusion, Aortic dissection, Central line catheterization, Arm swelling
All Articles
Download