Acute Airway Obstruction in a Uremic Patient After Undergoing Unsuccessful Bilateral Attempt of Permcath Catheterization

Abstract

We report a case with a history of HIV infection and uremia who developed a prominent neck hematoma and sudden airway obstruction resulting in sudden cardiovascular collapse after failed bilateral attempted subclavian Permcath implantation for hemodialysis. The patient had a history of twice previous Permcath malfunction resolved by urokinase infusion. Postoperatively, venography revealed bilateral central vein stenosis. This report demonstrates that preoperative venography is important to assess the possibility of central vein stenosis for this type of patient. We also suppose that bilateral rather than unilateral neck hematoma is an important factor for the development of acute airway obstruction in this patient. J Med Cases. 2011;2(2):51-54 doi: https://doi.org/10.4021/jmc127w