# Tunnelled dialysis catheter tract haemorrhage during mechanical thrombectomy of right atrial line-associated thrombus and line removal: a case report

## TL;DR

A child with a dialysis line developed a blood clot in the heart, and doctors faced challenges managing bleeding after removing the line.

## Contribution

This case report highlights the management of tract haemorrhage during mechanical thrombectomy in a pediatric patient.

## Key findings

- Tract haemorrhage occurred after mechanical thrombectomy and line removal in a child with a right atrial thrombus.
- Haemostasis was achieved using compression and sealing of the subcutaneous tract.
- The case demonstrates the complexity of managing thrombosis and bleeding in pediatric patients.

## Abstract

Central venous access catheter (CVC) devices are a critical part of care in patients with a variety of treatment needs but are not without complications.

A 5-year-old male child with a background of autosomal recessive nephrotic syndrome developed a septic right atrial thrombus related to his dialysis line. Mechanical thrombectomy and line removal was complicated by tract haemorrhage, requiring the integrated management of thrombosis and haemorrhage. Haemostasis was achieved with combination of compression and sealing of the subcutaneous tract.

This case provides an excellent example of tract haemorrhage demonstrated fluoroscopically. We discuss the available treatment options, which may need to be employed in urgent or emergent fashion, in paediatric patients with differing physiological reserves.