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Tunnelled central venous catheter–induced thrombosis: a rare case of superior vena cava syndrome

Published online by Cambridge University Press:  21 May 2015

Sandeep K. Aggarwal  and
William McCauley
Sandeep K. Aggarwal*
Affiliation:
Schulich School of Medicine, University of Western Ontario, London, Ont.
William McCauley
Affiliation:
Department of Emergency Medicine, University of Western Ontario, LondonOnt.
*
3530 Irwin Crt., Mississauga ON L5L 4W4; 905 820-7693, saggarwal2006@meds.uwo.ca

Abstract

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Thrombotic venous obstruction in patients with a tunnelled central venous catheter is a cause of superior vena cava syndrome that is not routinely encountered by emergency physicians. Diagnosis requires identifying patients at risk (e.g., those under treatment for cancer and those who have a tunnelled central venous catheter), recognizing the signs and symptoms of superior vena cava syndrome, usually dyspnea and dilated neck or thoracic veins, and imaging the venous obstruction using computer tomography or sonography. Management involves anticoagulation and local thrombolytic administration. We report the case of a 28-year-old woman who presented with a 2-day history of face, chest and bilateral arm swelling who had been receiving maintenance chemotherapy for acute lymphoblastic leukemia through a Hickman® catheter. This case demonstrates the need to be vigilant for thrombus formation in patients with long-term, indwelling central venous catheters.

Keywords

tunnelled central venous cathetercatheter-induced thrombosisanticoagulationthrombolyticssuperior vena cava syndrome
Type
Case Report • Observations de cas
Information
Canadian Journal of Emergency Medicine , Volume 7 , Issue 4 , July 2005 , pp. 273 - 277
Copyright
Copyright © Canadian Association of Emergency Physicians 2005

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