Use of the Superficialized Brachial Artery as Vascular Access for a Patient with Myasthenia Gravis with a Frequent Need for Plasmapheresis: A Case Report

Fumiya Kitano; Yuhji Marui; Kenzo Sakurai; Yugo Shibagaki; Tsutomu Sakurada; Shigeki Kojima

doi:10.2169/internalmedicine.2990-23

Fumiya Kitano, Yuhji Marui, Kenzo Sakurai, Yugo Shibagaki, Tsutomu Sakurada, Shigeki Kojima

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Keywords: blood purification therapy, myasthenia gravis, subcutaneously fixed superficial brachial artery, permanent vascular access

JOURNAL OPEN ACCESS Advance online publication

Article ID: 2990-23

DOI https://doi.org/10.2169/internalmedicine.2990-23

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Abstract

A 41-year-old woman diagnosed with seronegative myasthenia gravis struggled to maintain remission for a decade, facing crises every 3 months for several years. After repeated apheresis using a non-tunneled non-cuffed central venous dialysis catheter (NTNCC), complications such as catheter-related thrombus in the internal jugular veins and morbid obesity from steroids made the insertion of NTNCC increasingly difficult, leading to consideration of an alternative permanent vascular access (VA) approach. Thus, we created a subcutaneously superficialized brachial artery as the VA, which allowed the patient to undergo safe and uninterrupted apheresis therapy.

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