Piedade Ana, Domingues Patrícia, Natário Ana, Barreto Carlos, Parreira Lúcia
Nephrology, Setubal Hospital Center, Setubal, PRT.
Cureus. 2023 Feb 28;15(2):e35579. doi: 10.7759/cureus.35579. eCollection 2023 Feb.
When the left cardinal vein fails to involute during fetal life, a persistent left superior vena cava (PLSVC) develops. PLSVC is a rare vascular anomaly, and the reported incidence is 0.3-0.5% in healthy individuals. It is usually asymptomatic and does not cause hemodynamic disturbances unless associated with cardiac malformations. If the PLSVC drains adequately into the right atrium and there are no cardiac abnormalities, catheterization of this vessel, including temporary and cuffed HD catheter insertion, is deemed safe. We present the case of a 70-year-old woman with acute kidney injury (AKI), in which the necessity to place an HD central venous catheter (CVC) through the left internal jugular vein led to the discovery of a PLSVC. Once it was shown that the vessel was adequately draining into the right atrium, this catheter was changed to a cuffed tunneled HD catheter, which was successfully utilized for HD sessions for three months and removed after the recuperation of renal function without complications.
当左主静脉在胎儿期未能退化时，就会形成持续左上腔静脉（PLSVC）。PLSVC是一种罕见的血管异常，健康个体中的报告发病率为0.3 - 0.5%。它通常无症状，除非与心脏畸形相关，否则不会引起血流动力学紊乱。如果PLSVC能充分引流至右心房且无心脏异常，对该血管进行插管，包括插入临时和带袖套的血液透析（HD）导管，被认为是安全的。我们报告一例70岁急性肾损伤（AKI）女性病例，在该病例中，通过左颈内静脉放置HD中心静脉导管（CVC）的必要性导致发现了PLSVC。一旦证明该血管能充分引流至右心房，就将该导管更换为带袖套的隧道式HD导管，该导管成功用于HD治疗三个月，在肾功能恢复后拔除，无并发症。
