Hemodialysis Reliable Outflow device impingement in the subclavian position: a case report.

Journal Article (Journal Article)

PURPOSE: The purpose of this study is to report a case of Hemodialysis Reliable Outflow (HeRO) device malfunction in the subclavian position secondary to costoclavicular impingement. METHODS AND RESULTS: The electronic medical record was reviewed for the patient in question and pertinent imaging was collected and photographs were taken with the patient's consent. The patient presented with signs of outflow obstruction after a period of HeRO venous outflow component function. The outflow component was found to be crushed between the first rib and the clavicle at the costoclavicular junction. CONCLUSIONS: This case suggests that costoclavicular impingement should be considered as a mode of outflow failure with the HeRO outflow component in the subclavian position. Other central venous access points should be considered first, and the central veins accessed through the lower extremities are possible alternatives if this failure mode was to arise. First rib resection would also be a viable strategy to relieve impingement at this site.

Full Text

Duke Authors

Cited Authors

  • Yerxa, J; Gage, SM; Lawson, JH

Published Date

  • 2015

Published In

Volume / Issue

  • 16 / 5

Start / End Page

  • 428 - 430

PubMed ID

  • 25791275

Electronic International Standard Serial Number (EISSN)

  • 1724-6032

Digital Object Identifier (DOI)

  • 10.5301/jva.5000380


  • eng

Conference Location

  • United States