Novel treatment of vascular injury from delayed hemodialysis catheter migration by transvenous balloon-assisted embolization with n-butyl cyanoacrylate.

Fujitsuna, Ryutaro; Sugihara, Fumie; Yasui, Daisuke; Saito, Hidemasa; Ueda, Tatsuo; Shirai, Sayaka; Matsumoto, Taiga; Miyagi, Yasuo; Kumita, Shin-Ichiro

Delayed vascular injury (DVI) with a hemodialysis catheter is a rare but potentially life-threatening complication. However, the appropriate treatment for DVI has not yet been established. A 44-year-old man underwent placement of a hemodialysis catheter via the left internal jugular vein, and the first leukapheresis procedure was performed without complications. However, 3 days after the insertion of the hemodialysis catheter, the patient developed sudden dyspnea. Chest radiographs and contrast-enhanced computed tomography revealed that the catheter tip had migrated and was located outside the left brachiocephalic vein. DVI with catheter migration was diagnosed. To perform safe and reliable hemostasis, we successfully performed transvenous balloon-assisted tract embolization with n-butyl cyanoacrylate and the catheter was removed. To our knowledge, there has been no previous report of the treatment of balloon-assisted tract embolization with n-butyl cyanoacrylate for DVI caused by a hemodialysis catheter. Our treatment approach may be safe and effective for DVI.