Early complications of translumbar cannulation of the inferior vena cava as a quick, last-chance method of gaining access for hemodialysis. Ten years of experience in one clinical center.

Abstract

Introduction The gold standard of vascular access for chronic hemodialysis patients is the arteriovenous fistula (AVF). If an AVF cannot be created, the hemodialysis catheter can be inserted into the internal jugular, femoral or subclavian vein. After exhausting the abovementioned standard accesses, translumbar access to the inferior vena cava (IVC) is considered a quick, last-chance and rescue method. Aim Retrospective analysis of early complications (EC) of translumbar IVC catheterization using one type of catheter by one medical team. Material and methods From January 2010 to October 2019, a total of 34 translumbar IVC catheters were implanted in 27 patients. Results A major EC was found in 1 (2.9%) procedure. Minor EC occurred in 23.5 attempts. None of these complications required an intervention. Conclusions In patients with exhausted possibilities of obtaining standard vascular access for HD, translumbar IVC cannulation proved to be a safe and effective method.

Placing an appropriate tunneled dialysis catheter in an appropriate patient including the nonconventional sites

“…As originally described in 1995, this approach involves the percutaneous access of the IVC at approximately the level of the L3 vertebral body under fluoroscopic or CT guidance ( 42 ). Though approach has been universally associated with low peri-procedural complications, serious complications such as retroperitoneal hematomas and iatrogenic aortic punctures have been described ( 43 ). Particular complications associated with this technique include migration of the catheter in subcutaneous soft tissues and migration of the catheter tip into the iliac veins, particularly in obese patients, making morbid obesity a relative contraindication ( 44 ).…”