Hemorrhagic pericardial tamponade in a hemodialysis patient with catheter- related superior vena cava syndrome: A case report

Background: Iatrogenic complications of intravascular treatment for central venous stenosis have not yet been reported. Case presentation Here we present a case of a 72-year-old male patient on maintenance hemodialysis who developed catheter-related superior vena cava syndrome and subsequently suffered from hemorrhagic pericardial tamponade after undergoing percutaneous transluminal angioplasty and stenting. The patient initially presented with dysfunction of the dialysis catheter (a cuffed tunneled double-lumen catheter in the right internal jugular vein). Imaging examination revealed clear occlusion of the downstream superior vena cava, significant compensatory dilatation of the azygos vein, and abundant subcutaneous collaterals. The patient underwent percutaneous transluminal angioplasty and stenting of the superior vena cava. Unfortunately, postoperative hemorrhagic pericardial tamponade occurred and the patient developed cardiogenic shock. Conclusions: The case emphasizes the need for increased attention to iatrogenic endovascular injuries during catheter placement and intravascular treatment.