モリモト　サトシ   MORIMOTO Satoshi   森本　聡    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Successful permanent catheter implantation after percutaneous transluminal angioplasty to the right subclavian and inominate vein stenosis in a hemodialysis patient.
掲載誌名	正式名：Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy 略　 称：Ther Apher Dial ISSNコード：17449987/17449979
掲載区分	国外
巻・号・頁	14(1),pp.108-11
著者・共著者	Nishioka Hiroaki, Morimoto Satoshi*, Yurugi Takatomi, Nishikawa Mitsushige, Iwasaka Toshiji, Maki Kei
担当区分	2nd著者,責任著者
発行年月	2010/02
概要	Difficulties in gaining vascular access have become one of the major problems in long-term hemodialysis patients. We report a case with an extreme vascular access problem, which was solved by the placement of a permanent central vein catheter after successful angioplasty to the right subclavian and inominate vein stenosis. A 78-year-old woman with end-stage renal disease due to diabetic nephropathy had been on hemodialysis since 1982. She had a history of four procedures that created an arteriovenous fistula during the first four years. In 1986 she was switched to peritoneal dialysis. However, hemodialysis was restarted with a regular arteriovenous fistula in 1991 because of repeated peritonitis, and from 1993 a superficialized brachial artery was used until the artery was exhausted. Since 1997, a permanent central vein catheter was utilized and reinsertion was required four times due to catheter infection during a 6-year period. In 2004, difficulty was experienced in reinserting a new central venous catheter because of multiple stenotic and occlusive lesions of the central veins. Percutaneous transluminal angioplasty was carried out in the stenotic right subclavian and inominate veins, and after successful angioplasty, a permanent central vein catheter could be placed into the right subclavian vein as a vascular access for hemodialysis. Pretreatment with percutaneous transluminal angioplasty of the stenotic central veins before inserting a permanent catheter may be a useful strategy in patients that experience difficulty in the insertion of a catheter.
DOI	10.1111/j.1744-9987.2009.00709.x
PMID	20438527