Udaipur, 54 years female patient with a history of renal failure & exhausted conventional routes of central and peripheral venous access because of obstruction or thrombosis; was treated with feasible, nonsurgical solution percutaneous Translumbar placement of inferior vena cava (IVC) catheter for long-term access. The procedure was successfully performed by Geetanjali Medical College & Hospital’s Nephrologist Dr. G K Mukhiya & Neuro Vascular Interventional Radiologist Dr. Seetaram Barath. This has been claimed a first successful case in Rajasthan.
Chandra Kala Tondon, 54 years, was a patient of renal failure & was surviving on dialysis. Suddenly all the veins through which dialysis catheter was inserted were blocked & she was recommended for kidney transplant. To confirm the same & to have a second opinion she visited Geetanjali Hospital for consultation with nephrologist Dr. G K Mukhiya.
As dialysis is performed with the help of fistula, but in this patient fistula had failed three times. The veins of throat & legs were also used for dialysis which in turn had become infectious & obstructed leading to no dialysis through these. Peritoneal dialysis was also not possible as the patient was suffering from hernia & infections in veins. The patient had not undergone for dialysis for past 8 days leading to swelling in body & no urine. She was bounded to bed & was unable to carry her daily routine work.
With immediate assistance & help of Neuro Vascular Interventional Radiologist Dr. Seetaram Barath, the patient was shifted to cath lab as the fluoroscopic and sonographic guidance is available, is the optimal environment for catheter placement. Investigation of Angiography was performed by the doctors to confirm if grafting is possible in veins of the neck. But they were also blocked.
Dr. G K Mukhiya, the treating doctor told that, Access to the central venous circulation for hemo-dialysis has traditionally been achieved via the sub clavian or jugular venous routes. With ongoing improvements in medical management, many hemo-dialysis recipients develop exhaustion of these routes and require alternative means of central venous access. Inferior vena cava (IVC) catheter was placed with a percutaneous translumbar approach to allow dialysis of the patient. The procedure took 3 hours to be completed. A special catheter from New Delhi was bought & with the help of 15 centimeters needle the catheter was placed in inferior vena cava. It was a life saving procedure for the patient on which she could survive long. It was a risky procedure but the patient recovered well.
Translumbar placement of WC catheters is performed only in patients considered to have few or no other medical options.
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