Malpositioned right subcalvian tunnelled catheter and complications of the left pleural cavity

Abstract

Introduction: The best way of haemodialysis for patients with Chronic Kidney Disease (CKD), is the arteriovenous fistula, but sometimes the difficulties of this method lead to the percutaneous catheterization of the central vein as a temporary or permanent access. Case report: The catheterization of the right subclavian vein in a 73 years old patient with end-stage-renal disease was described in this report. The catheter placed in the wrong position, which passed outside of the superior vena cava and entered into the left pleural cavity causing hemoand pneumothorax. Discussion: The most preferred vascular access for haemodialysis is the internal jugular vein, due to the fact that it is associated with less complications. Malposition of a Subclavian Catheter Venus (SCV) tunnelled occurs in 1,8% to 3,7%. The preferred method is the real time ultrasound guided cannulation. Conclusion: The position of the catheter should be checked regularly and systematically. Malpositioning should be diagnosed as fast as possible and the right management of complications and removal of the catheter are the first priorities.