Hemodialysis Tunneled Catheter Noninfectious Complications

Miller, Lisa; MacRae, Jennifer M.; Kiaii, Mercedeh; Clark, Edward G.; Dipchand, Christine; Kappel, Joanne; Luscombe, Rick; Moist, Louise; Oliver, Matthew J.; Pike, Pamela D.

doi:10.1177/2054358116669130

Cited by 57 publications

(63 citation statements)

References 78 publications

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“…Unfortunately, for various reasons including patient factors[2, 20], long term catheter use remains quite common, and, as a consequence, the need to recognize and appropriately handle embedded catheters remains of paramount importance.…”

Section: Discussionmentioning

confidence: 99%

Endoluminal dilatation for embedded hemodialysis catheters: A case-control study of factors associated with embedding and clinical outcomes

et al. 2017

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BackgroundWith the increasing frequency of tunneled hemodialysis catheter use there is a parallel increase in the need for removal and/or exchange. A small but significant minority of catheters become embedded or ‘stuck’ and cannot be removed by traditional means. Management of embedded catheters involves cutting the catheter, burying the retained fragment with a subsequent increased risk of infections and thrombosis. Endoluminal dilatation may provide a potential safe and effective technique for removing embedded catheters, however, to date, there is a paucity of data.Objectives1) To determine factors associated with catheters becoming embedded and 2) to determine outcomes associated with endoluminal dilatationMethodsAll patients with endoluminal dilatation for embedded catheters at our institution since Jan. 2010 were included. Patients who had an embedded catheter were matched 1:3 with patients with uncomplicated catheter removal. Baseline patient and catheter characteristics were compared. Outcomes included procedural success and procedure-related infection. Logistic regression models were used to determine factors associated with embedded catheters.ResultsWe matched 15 cases of embedded tunneled catheters with 45 controls. Among patients with embedded catheters, there were no complications with endoluminal dilatation. Factors independently associated with embedded catheters included catheter dwell time (> 2 years) and history of central venous stenosis.ConclusionEmbedded catheters can be successfully managed by endoluminal dilatation with minimal complications and factors associated with embedding include dwell times > 2 years and/or with a history of central venous stenosis.

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Section: Discussionmentioning

confidence: 99%

Endoluminal dilatation for embedded hemodialysis catheters: A case-control study of factors associated with embedding and clinical outcomes

et al. 2017

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“…USG, göğüs kafesindeki kemikler ve örtüşen yumuşak dokunun karışması nedeniyle santral venlerin değerlendiril-mesinde optimal değildir. Ancak, USG radyokontrast kullanımını önlediği ve kontrast maddelerden kaçı-nılması gereken olgularda (Örneğin, kontrast alerji) düşünülmesi gerektiği bildirilmiştir [5] . Olgumuzda santral stenoz 2. katetarizasyon işleminde USG ile rastlantı sonucu fark edildi.…”

Section: Discussionunclassified

Venous Stenosis Due to Central Venous Catheter in a Child who is Liver Transplant Recipient

Erdoğan¹,

Çolak²,

Kaçmaz³

et al. 2017

GKDA Derg

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“…Adhesion of collagen to the smooth muscle cells of the venous wall is followed by the migration towards the tip of the catheter during the following weeks (11). Depending on the patients' profile of coagulation factors, inherited and acquired traits, the formation rate varies.…”

Section: Discussionmentioning

confidence: 99%

“…The interaction between white blood cells, coagulation factors and platelets, and the fibrin sheath elevates the promotion of the sheath (11). Adhesion of collagen to the smooth muscle cells of the venous wall is followed by the migration towards the tip of the catheter during the following weeks (11).…”

Section: Discussionmentioning

confidence: 99%

Approach to the occluded permanent hemodialysis catheter

Kerem¹,

Sevdi²,

Demirgan³

et al. 2017

Bagcilar Medical Bulletin

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Objective: Central venous catheterization (CVC) is a type of surgery that hemodialysis (HD) patients frequently undergo. Presently, permanent CVCs (pCVCs) are the alternative to vascular access for patients requiring long-term catheterization. Additionally, identification of the type of catheter has a great importance for the right intervention. Our study aims:The aim was to discuss the identification procedure of an HD catheter, whether it is permanent or temporary, by presenting an HD catheter case done by CVC. Case presentation:A 75-year-old female patient having a routine of 3 days/week HD treatment was admitted to the critical care unit. A nonfunctional HD catheter was present in the left subclavian vein. A new HD catheter was placed in the right subclavian vein and continuous renal replacement therapy with heparin was initiated. Radiography revealed an opacity with a size of around 3 cm detected at the tip of the nonfunctional catheter. The catheter was removed with an incision after an unsuccessful attempt of removal by pulling it out. Further investigation of the catheter revealed that it was occluded. Conclusion:It is crucial to determine whether the catheter is temporary or permanent in order to do the right intervention and not to have unwanted consequences while removing a nonfunctional HD catheter. Keywords: kidney failure, hemodialysis, catheter obstruction ÖZET Oklüze olmuş kalıcı hemodiyaliz kateterine yaklaşımAmaç: Santral venöz kateterizasyon hemodiyaliz uygulanacak hastalarda sık uygulanan bir prosedürdür. Uzun süre hemodiyaliz ve kateterizasyon ihtiyacı olan hastalarda kalıcı santral venöz kateterizasyon vasküler erişim için alternatif bir yöntem olmuştur. Kateterin tipinin belirlenmesi doğru girişimin yapılabilmesi için büyük önem taşımaktadır.Bu yazının amacı geçici ve kalıcı hemodiyaliz kateterizasyonunun uygulanma yöntemlerini tartışmaktır.Yetmiş beş yaşında, haftada 3 kez hemodiyaliz tedavisi alan kadın hasta, yoğun bakım ünitemize interne edildi. Sol subklavian vende non-fonksiyonel hemodiyaliz kateteri mevcuttu. Sağ subklavian vene yeni hemodyaliz kateteri yerleştirildi ve heparinli sürekli renal replasman tedavisi başlandı. Radyolojik incelemede non-fonksiyonel kateterin uç kısmında 3 cm uzunluğunda opasite tespit edildi. Kateter çekilerek çıkarılamayınca cilt insizyonu eşliğinde çıkarıldı. Sonrasında yapılan incelemede kateterin tıkanmış olduğu tespit edildi. Sonuç:Geçici ve kalıcı non-fonksiyonel hemodiyaliz kateterlerinin çıkarılması sırasında doğru girişimin yapılması hayati önem taşımaktadır.Anahtar kelimeler: böbrek yetmezliği, hemodiyaliz, kateter tıkanıklığı, santral venöz kateterizasyon

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Hemodialysis Tunneled Catheter Noninfectious Complications

Cited by 57 publications

References 78 publications

Endoluminal dilatation for embedded hemodialysis catheters: A case-control study of factors associated with embedding and clinical outcomes

Endoluminal dilatation for embedded hemodialysis catheters: A case-control study of factors associated with embedding and clinical outcomes

Venous Stenosis Due to Central Venous Catheter in a Child who is Liver Transplant Recipient

Approach to the occluded permanent hemodialysis catheter

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