{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T22:47:17Z","timestamp":1777848437283,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T00:00:00Z","timestamp":1611273600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>The health care system in Peru treats 15,000 dialysis patients annually. Approximately 45% of patients receive therapy using catheters. The incidence of catheter-induced superior vena cava (SVC) occlusion is increasing along with its associated significant morbidity and vascular access dysfunction. One of the unusual manifestations of this complication is bleeding \u201cdownhill\u201d esophageal varices caused by reversal of blood flow through esophageal veins around the obstruction to the right atrium. Herein is presented the case of an 18-year-old woman on hemodialysis complicated by SVC occlusion and bleeding esophageal varices who underwent successful endovascular recanalization of the SVC. Bleeding from \u201cdownhill\u201d esophageal varices should be considered in the differential diagnosis of dialysis patients exposed to central venous catheters. Aggressive endovascular treatment of SVC occlusion is recommended to preserve upper extremity access function and prevent bleeding from this complication.<\/jats:p>","DOI":"10.1177\/1526602821989330","type":"journal-article","created":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T15:45:06Z","timestamp":1611330306000},"page":"469-473","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Management of Superior Vena Cava Occlusion Causing Bleeding \u201cDownhill\u201d Esophageal Varices"],"prefix":"10.1177","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7102-1365","authenticated-orcid":false,"given":"Pablo V.","family":"Uceda","sequence":"first","affiliation":[{"name":"DFW Vascular Group, Dallas, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julio","family":"Peralta Rodriguez","sequence":"additional","affiliation":[{"name":"Thoracic and Cardiovascular Surgery, Hospital Nacional Dos de Mayo, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hern\u00e1n","family":"Vela","sequence":"additional","affiliation":[{"name":"Thoracic and Cardiovascular Surgery, Hospital Nacional Dos de Mayo, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adelina","family":"Lozano Miranda","sequence":"additional","affiliation":[{"name":"Gastroenterology, Hospital Nacional Arzobispo Loayza. Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Vega Salvatierra","sequence":"additional","affiliation":[{"name":"Thoracic and Cardiovascular Surgery, Hospital Nacional Dos de Mayo, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Feldtman","sequence":"additional","affiliation":[{"name":"DFW Vascular Group, Dallas, TX, USA"},{"name":"TCU School of Medicine, Fort Worth, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam S.","family":"Ahn","sequence":"additional","affiliation":[{"name":"DFW Vascular Group, Dallas, TX, USA"},{"name":"TCU School of Medicine, Fort Worth, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,1,22]]},"reference":[{"key":"bibr1-1526602821989330","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfy150"},{"key":"bibr2-1526602821989330","doi-asserted-by":"publisher","DOI":"10.1097\/01.MAT.0000151921.95165.1E"},{"key":"bibr3-1526602821989330","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2018.11.13"},{"key":"bibr4-1526602821989330","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-017-1787-x"},{"key":"bibr5-1526602821989330","doi-asserted-by":"publisher","DOI":"10.1378\/chest.46.6.740"},{"key":"bibr6-1526602821989330","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-016-0548-7"},{"key":"bibr7-1526602821989330","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(98)70331-1"},{"key":"bibr8-1526602821989330","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2003.10.026"},{"key":"bibr9-1526602821989330","doi-asserted-by":"publisher","DOI":"10.4321\/S1130-01082006000500006"},{"key":"bibr10-1526602821989330","doi-asserted-by":"publisher","DOI":"10.1097\/RCT.0000000000000183"},{"key":"bibr11-1526602821989330","first-page":"216","volume":"97","author":"Blam ME","year":"2002","journal-title":"Am J Gastroenterol"},{"key":"bibr12-1526602821989330","doi-asserted-by":"publisher","DOI":"10.1378\/chest.128.3.1868"},{"key":"bibr13-1526602821989330","first-page":"188","volume":"62","author":"Taylor SM","year":"1996","journal-title":"Am Surg"},{"key":"bibr14-1526602821989330","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.09240912"},{"key":"bibr15-1526602821989330","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2007.09.071"}],"container-title":["Journal of Endovascular Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1526602821989330","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1526602821989330","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1526602821989330","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:34:28Z","timestamp":1777498468000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1526602821989330"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,22]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1177\/1526602821989330"],"URL":"https:\/\/doi.org\/10.1177\/1526602821989330","relation":{},"ISSN":["1526-6028","1545-1550"],"issn-type":[{"value":"1526-6028","type":"print"},{"value":"1545-1550","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,22]]}}}