Work

Percutaneous Mechanical Thrombectomy of a Superior Vena Cava and Right Atrial Thrombus Complicating a Malfunctioning Tunneled Dialysis Catheter

Year: 2026

Type: article

Abstract: Tunneled dialysis catheters are a mainstay of hemodialysis access but are complicated over time by central venous stenosis and catheter-related thrombus, both of which can impair catheter function and threaten future access. We describe the case of a 77-year-old woman who required hemodialysis for acute kidney injury on underlying chronic kidney disease and, within weeks of placement of her first right internal jugular tunneled dialysis catheter, developed superior vena cava (SVC) stenosis and an organized thrombus at the cavoatrial junction extending into the right atrium (RA). The thrombus caused catheter malfunction with low flow and clotting. Cardiac computed tomography confirmed the SVC/RA thrombus. In a single percutaneous session, mechanical thrombectomy, SVC angioplasty, and catheter exchange achieved complete thrombus clearance and a widely patent SVC, and restored catheter function without thrombolysis or open surgery. This case illustrates thrombolytic-free mechanical thrombectomy as an effective, thrombolytic-free treatment option for catheter-associated SVC/RA thrombus that preserves dialysis access in a single sitting.

Source: Cureus

DOI: 10.7759/cureus.115590

Authors: Renato Abu Hana, Grit A Adler, Ryosuke Miyauchi, Vinicius Adami Vayego Fornazari

Institutions: University of Florida, University of Florida Health Science Center

Language: English

Topic: Central Venous Catheters and Hemodialysis

Subfield: Emergency Medical Services

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7204934050