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Nursing Cooperation in a Patient with Superior Vena Cava Aneurysm Undergoing Contrast-Enhanced CT Examination: A Case Report

Received: 3 February 2021     Accepted: 26 February 2021     Published: 4 March 2021
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Abstract

Superior vena cava aneurysm is a rare life-threatening intrathoracic vascular lesion. Contrast-enhanced CT examination plays an important role for surgical planning. It needs to choose the appropriate vein as the puncture site for contrast agent injection. Hereby we report a 22-year-old male presented with sudden-onset dyspnea and unconsciousness for 2 hours and suffered from cardiac arrest before visiting our hospital. The patient's condition is critically ill, and the risk of contrast agent extravasation and aneurysm explosion is high. We established a multi-disciplinary team, involving Emergency Department, Cardiac Surgery Department, Radiological Department and intravenous therapy experts, for the integrated assessment of patients. And we activate the emergency cooperation protocol for critically ill patients. The superior vena cava can’t be used for contrast injection. Anatomically, the femoral vein drains blood back to the heart through the inferior vena cava, which could avoid the risk of rupture of the superior vena cava aneurysm due to excessive pressure of bolus injection of contrast agent. The indwelling of femoral vein puncture can be used in the treatment of critically ill patients. The vital signs of patients were closely observed during the examination process. No contrast agent extravasation and allergy reaction was observed and CT images were clear. The effective nursing cooperation in this case ensured the safety and effectiveness of the examination, and laid the foundation for further treatment.

Published in American Journal of Nursing Science (Volume 10, Issue 2)
DOI 10.11648/j.ajns.20211002.12
Page(s) 124-127
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Superior Vena Cava Aneurysm, Femoral Vein, Contrast-Enhanced CT, Nursing Cooperation

References
[1] Morales MM, Anacleto A, Ferreira Leal JC, et al. Saccular Superior Vena Cava Aneurysm: Case Report and Comprehensive Review. Ann Vasc Surg. 2020 Dec 14: S0890-5096(20)31021-9.
[2] Nunnelee JD. Superior vena cava syndrome. J Vasc Nurs. 2007 Mar; 25 (1): 2-5; quiz 6.
[3] Nakajima Y, Minami T, Ishigaki H, et al. A superior vena cava aneurysm discovered by chance at regular physical examination. Respir Investig. 2020 Jul; 58 (4): 291-294.
[4] Nair AA, Christopher DJ, Moidu F, et al. Superior vena caval obstruction: a rare presentation of Behcet's disease. BMJ Case Rep. 2020 Dec 17; 13 (12): e236658.
[5] Soares Souza LV, Souza AS, et al. Superior vena cava aneurysm: an unusual mediastinal mass. Eur J Cardiothorac Surg. 2021 Jan 4; 59 (1): 276-277.
[6] Sonavane SK, Milner DM, Singh SP, et al. Comprehensive Imaging Review of the Superior Vena Cava. Radiographics. 2015 Nov-Dec; 35 (7): 1873-92.
[7] Tan PY, Tham WP, Yong YR. Clinics in diagnostic imaging (194). SVC aneurysm. Singapore Med J. 2019 Jan; 60 (1): 17-21.
[8] Witting MD, Moayedi S, Dunning K, et al. Power Injection Through Ultrasound-Guided Intravenous Lines: Safety and Efficacy Under an Institutional Protocol. J Emerg Med. 2017 Jan; 52 (1): 16-22.
[9] Sánchez Matás C, Manresa Manresa F, Andrades Sardiña D, et al. Thoracoscopic approach of iatrogenic superior vena cava perforation after dialysis catheter placement. Cir Esp. 2020 Jun-Jul; 98 (6): 364-366.
[10] Zhang HY, Lian WS, Chai DZ. Large asymptomatic superior vena cava aneurysm. J Vasc Surg Venous Lymphat Disord. 2019 Jul; 7 (4): 591.
[11] Safety Committee of Japanese Society of Anesthesiologists. Practical guide for safe central venous catheterization and management 2017. J Anesth. 2020 Apr; 34 (2): 167-186.
[12] Saugel B, Umgelter A, Schuster T, et al. Transpulmonary thermodilution using femoral indicator injection: a prospective trial in patients with a femoral and a jugular central venous catheter. Crit Care. 2010; 14 (3): R95. doi: 10.1186/cc9030.
[13] Schoenfeld AJ, Beck AW, Harris MB, et al. Evaluating the Cervical Spine in the Blunt Trauma Patient. J Am Acad Orthop Surg. 2019 Sep 1; 27 (17): 633-641.
[14] Chen Z, Ishizuka O, Imamura T, et al. Role of alpha1-adrenergic receptors in detrusor overactivity induced by cold stress in conscious rats. Neurourol Urodyn. 2009; 28 (3): 251-6.
[15] Park HJ, Son JH, Kim TB, et al. Relationship between Lower Dose and Injection Speed of Iodinated ContrastMaterial for CT and Acute Hypersensitivity Reactions: An Observational Study. Radiology. 2019 Dec; 293 (3): 565-572.
Cite This Article
  • APA Style

    Shaofang Xian, Li Hairui. (2021). Nursing Cooperation in a Patient with Superior Vena Cava Aneurysm Undergoing Contrast-Enhanced CT Examination: A Case Report. American Journal of Nursing Science, 10(2), 124-127. https://doi.org/10.11648/j.ajns.20211002.12

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    ACS Style

    Shaofang Xian; Li Hairui. Nursing Cooperation in a Patient with Superior Vena Cava Aneurysm Undergoing Contrast-Enhanced CT Examination: A Case Report. Am. J. Nurs. Sci. 2021, 10(2), 124-127. doi: 10.11648/j.ajns.20211002.12

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    AMA Style

    Shaofang Xian, Li Hairui. Nursing Cooperation in a Patient with Superior Vena Cava Aneurysm Undergoing Contrast-Enhanced CT Examination: A Case Report. Am J Nurs Sci. 2021;10(2):124-127. doi: 10.11648/j.ajns.20211002.12

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  • @article{10.11648/j.ajns.20211002.12,
      author = {Shaofang Xian and Li Hairui},
      title = {Nursing Cooperation in a Patient with Superior Vena Cava Aneurysm Undergoing Contrast-Enhanced CT Examination: A Case Report},
      journal = {American Journal of Nursing Science},
      volume = {10},
      number = {2},
      pages = {124-127},
      doi = {10.11648/j.ajns.20211002.12},
      url = {https://doi.org/10.11648/j.ajns.20211002.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20211002.12},
      abstract = {Superior vena cava aneurysm is a rare life-threatening intrathoracic vascular lesion. Contrast-enhanced CT examination plays an important role for surgical planning. It needs to choose the appropriate vein as the puncture site for contrast agent injection. Hereby we report a 22-year-old male presented with sudden-onset dyspnea and unconsciousness for 2 hours and suffered from cardiac arrest before visiting our hospital. The patient's condition is critically ill, and the risk of contrast agent extravasation and aneurysm explosion is high. We established a multi-disciplinary team, involving Emergency Department, Cardiac Surgery Department, Radiological Department and intravenous therapy experts, for the integrated assessment of patients. And we activate the emergency cooperation protocol for critically ill patients. The superior vena cava can’t be used for contrast injection. Anatomically, the femoral vein drains blood back to the heart through the inferior vena cava, which could avoid the risk of rupture of the superior vena cava aneurysm due to excessive pressure of bolus injection of contrast agent. The indwelling of femoral vein puncture can be used in the treatment of critically ill patients. The vital signs of patients were closely observed during the examination process. No contrast agent extravasation and allergy reaction was observed and CT images were clear. The effective nursing cooperation in this case ensured the safety and effectiveness of the examination, and laid the foundation for further treatment.},
     year = {2021}
    }
    

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    AU  - Shaofang Xian
    AU  - Li Hairui
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    AB  - Superior vena cava aneurysm is a rare life-threatening intrathoracic vascular lesion. Contrast-enhanced CT examination plays an important role for surgical planning. It needs to choose the appropriate vein as the puncture site for contrast agent injection. Hereby we report a 22-year-old male presented with sudden-onset dyspnea and unconsciousness for 2 hours and suffered from cardiac arrest before visiting our hospital. The patient's condition is critically ill, and the risk of contrast agent extravasation and aneurysm explosion is high. We established a multi-disciplinary team, involving Emergency Department, Cardiac Surgery Department, Radiological Department and intravenous therapy experts, for the integrated assessment of patients. And we activate the emergency cooperation protocol for critically ill patients. The superior vena cava can’t be used for contrast injection. Anatomically, the femoral vein drains blood back to the heart through the inferior vena cava, which could avoid the risk of rupture of the superior vena cava aneurysm due to excessive pressure of bolus injection of contrast agent. The indwelling of femoral vein puncture can be used in the treatment of critically ill patients. The vital signs of patients were closely observed during the examination process. No contrast agent extravasation and allergy reaction was observed and CT images were clear. The effective nursing cooperation in this case ensured the safety and effectiveness of the examination, and laid the foundation for further treatment.
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Author Information
  • Radiology Department, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou, China

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