Ji Dabin, Gill Anne Elizabeth, Ermentrout Robert Mitchell, Hawkins Clifford Matthew
Mercer University School of Medicine, Savannah, USA.
Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Emory University School of Medicine, Atlanta, USA.
J Radiol Case Rep. 2018 Apr 30;12(4):15-22. doi: 10.3941/jrcr.v12i4.3339. eCollection 2018 Apr.
Thrombogenic superior vena cava syndrome is an uncommon, dangerous complication of long-standing central venous catheter use. The increased use of central venous catheters has resulted in more non-malignant cases of superior vena cava syndrome across all age groups. We present a 5-year-old male with superior vena cava syndrome associated with acute onset of severe upper extremity and facial swelling, dyspnea, and a right subclavian central venous catheter malfunction. The patient was ultimately treated with percutaneous stenting of the superior vena cava with balloon-expandable Palmaz stents following unsuccessful angioplasty, catheter-directed thrombolysis, and percutaneous thrombectomy. This case highlights a relatively uncommon complication in children from long-term central venous catheter access and describes an emerging, minimally-invasive therapeutic alternative that allows for preservation of age-appropriate superior vena cava luminal diameter as patients grow.
血栓形成性上腔静脉综合征是长期使用中心静脉导管引起的一种罕见且危险的并发症。中心静脉导管使用的增加导致了各年龄组中更多非恶性的上腔静脉综合征病例。我们报告一名5岁男性，患有上腔静脉综合征，伴有急性严重上肢和面部肿胀、呼吸困难以及右锁骨下中心静脉导管故障。在血管成形术、导管定向溶栓和经皮血栓切除术失败后，该患者最终接受了使用球囊扩张式帕尔马兹支架对上腔静脉进行经皮支架置入治疗。本病例突出了长期中心静脉导管置入在儿童中相对罕见的并发症，并描述了一种新兴的微创治疗选择，该选择可在患者成长过程中保留适合其年龄的上腔静脉管腔直径。
