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Table 1 Timeline of clinical events

From: Hemodialysis catheter-associated superior vena cava syndrome and pulmonary embolism: a case report and review of the literature

Time

Event

Day 0

28yo woman with end-stage renal disease in the setting of IgA nephropathy undergoes right IJ tunneled HD catheter placed for initiation of hemodialysis

Day 47

Presents to outside hospital with SVC syndrome and started on intravenous heparin

Day 51

Transferred to our hospital with SVC syndrome and bacteremia (on IV heparin and IV vancomycin) for consideration of advanced interventions involving the HD catheter

Day 55

Due to the persistence of thrombus-associated SVC syndrome, HD catheter is removed and replaced; IV vancomycin and IV heparin are continued, and coumadin is initiated

Day 60

Develops right-sided chest pain with fever; CT angiography demonstrates R-sided pulmonary embolism

Day 63

Develops pleuritic chest pain with blood tinged sputum; CT chest demonstrates pulmonary infarction

Day 69

Resolution of symptoms; discharged with six-month course of coumadin, 28-day course of vancomycin, and outpatient hemodialysis

Day 268 (approximately 9 months after discharge)

Underwent renal transplant