Femoral Tunneled Catheter Insertion following Angioplasty in a Patient with Central Vein Stenosis

The number of end-stage renal disease (ESRD) patients is increasing globally. With the limited availability of donors for renal transplants, the number of patients on dialysis is also likely to increase. Vascular access is the Achilles heel for successful long-term dialysis. Many patients on long-term dialysis go into a state of multiple access failure. One of the most common complications a nephrologist faces is central vein stenosis. Here, we report one such patient with multiple access failures with complete occlusion of the right internal jugular vein and left brachiocephalic vein and also had complete occlusion of the right external iliac vein and common iliac vein. Hence, femoral tunneled catheter insertion after balloon angioplasty was done from the iliac vein to the infrarenal inferior vena cava (IVC), and the tip of the catheter was kept at suprarenal IVC.