Right intra-atrial catheter insertion at the end stage of peripheral vascular access for dialysis

Abstract

The number of patients with end-stage renal failure requiring dialysis keeps increasing every year. Many of these patients also suffer from peripheral arterial disease. We report the case of a middle age woman receiving dialysis who had undergone amputation of both lower limbs and suffered multiple deep venous thrombosis. Therefore, peripheral accesses for venous dialysis were not available. A catheter had to be implanted right into the right atrium.

Implantation of a hemodialysis catheter directly in the right atrium due to exhaustion of vascular access

“…Ten months after placement, the catheter was functioning at an adequate flow rate, no postoperative complications have been identified. The conclusion is that the method is an adequate option in patients without any other alternative (2).…”

“…The number of patients with end-stage renal failure requiring HD is increasing every year worldwide. The need for permanent vascular access for such patients is essential to ensure adequate flow for hemodialysis sessions (2). The problem of providing vascular access in patients with persistent HD is one of the main reasons for the need for hospitalization and mortality.…”

“…The problem of providing vascular access in patients with persistent HD is one of the main reasons for the need for hospitalization and mortality. Thrombosis is the most common complication and the main cause of loss of vascular access (3,4).…”

Life-saving vascular access in vascular capital exhaustion: single center experience in intra-atrial catheters for hemodialysis

“…Since then, there have been several case reports, [7][8][9] and three small series were published. [10][11][12] The experience with these catheters in HD is limited and, although their use remains restricted to life-saving situations of multiple venous access failure, with no other possibility of alternative RRT, an analysis of survival on HD with IAC and associated complications is essential to consider the best therapeutic options.…”

Epuisement du capital vasculaire en hémodialyse: quelle issue?

“…La thrombose de ce type de cathéter a été rapportée dans trois cas (11,1%) dans la littérature [16]. Dans d’autres études, l’oreillette droite a constitué une voie plus privilégiée que la veine cave supérieure pour l’emplacement du cathéter de dialyse tunnelisé [17, 18]. Cependant, les recommandations de pratique clinique ne sont pas tous unanimes pour le choix de cet accès vasculaire [17, 19].…”