Successful insertion of a tunneled-cuffed catheter in a patient with multiple stenoses of the central vein

摘要

This is a case of a 73-year-old woman, with a history of diabetes mellitus, diabetic nephropathy, and end-stage renal disease. Initially, continuous ambulatory peritoneal dialysis (CAPD) had been applied for 3 months, but was suspended due to CAPD catheter blocking. Subseouently, native arteriovenous fistulas (AVFs) of left wrist and right forearm, and an arteriovtnous graft of left upper limb were constructed, respectively. Unfortunately, they failed due to the poor condition of her vasculature which contributed to thrombus formation in the bilateral median cubital vein and artificial blood vessel 9 months after operation. In addition, the patient had central vein catheters (CVCs) repeatedly inserted which resulted in severe stenosis of the internal jugular vein and femoral vein.