Challenges in managing vascular complications and iatrogenic injuries in end-stage renal disease: A case report

Patients with end-stage renal disease (ESRD) who are on long-term hemodialysis are at heightened risk for vascular complications such as thrombosis, stenosis, and central venous obstruction. This case report presents the challenges in managing a 54-year-old female ESRD patient with multiple comorbidities who developed central venous occlusions, requiring endovascular interventions. Venoplasty of the superior vena cava (SVC) led to the rare but devastating complication of SVC rupture, cardiac tamponade, and hemothorax. Prompt recognition and immediate interventions, including balloon tamponade, pericardial drainage, and pleural catheter placement, were crucial in stabilizing the patient. This report highlights the intricate challenges in managing vascular complications and iatrogenic injuries in ESRD patients undergoing hemodialysis, emphasizing the need for the development of clinical guidelines to enhance care for this vulnerable population.