Right Internal Jugular Vein Catheterization for Hemodialysis Reveals Persistent Left Superior Vena Cava: A Rare Case Study

Persistent Left Superior Vena Cava (PLSVC) is a rare congenital vascular anomaly occurring in 0.3%-0.5% of the general population. While often asymptomatic, it may pose challenges during central venous catheterization. We report the case of a 24-year-old male with Stage 5 chronic kidney disease (CKD) requiring urgent hemodialysis. A right internal jugular vein catheter was successfully placed, but post-procedural imaging revealed an unusual catheter trajectory toward the left mediastinum. CT angiography confirmed PLSVC of Schummer's Type 2, characterized by the absence of the right superior vena cava and left SVC draining into the right atrium via a dilated coronary sinus. Hemodialysis was performed successfully with gradual flow rate adjustments and close monitoring. This case emphasizes the importance of early recognition and management of vascular anomalies to ensure procedural success.