Salvage Technique for Complicated Hemodialysis Patients with Central Venous Occlusion

Abstract

Background: Although safe, central venous catheters (CVCs) may cause several complications including central venous occlusions. The salvage access techniques are life-saving alternatives required for patients who have exhausted other access options.Technique: We present a technique of placing a permanent catheter in the femoral vein facing the dilated collaterals. This is done in case of iliac vein and vena cava thrombosis following placement of multiple CVCs. Conclusion:This technique might be an effective alternative to the translumbar approach when performed by an experienced operator in a well-equipped access center. It must not be attempted as a blind procedure.Salvaged access can be considered when other access options have been exhausted and only translumbar or transhepatic inferior vena cava accesses are left. Clinical significance:The CVCs remain the fastest, safe, and effective access for hemodialysis. As a last resort, lower extremity access may be considered. The presented salvage procedure is a modification of the routine CVC placement technique.

WHOQOL-BREF survey of quality of life among dialyzed end-stage renal disease patients

“…Additionally, HD may cause QOL impairments [1,2,16,17]. The ESRD patients, regardless of the treatment modality, have to manage many adversities: cognitive impairment, physical symptoms, fluid and dietary restriction, and changed body image [3,5,6,15,18,19]. They may have many risk factors of reduced QOL such as diabetes, hypertension, dyslipidemia, hypoxemia, proinflammatory state, as well as fluid, osmolar and uremic toxin variations [6].…”

One-stage basilic vein tunneled transposition for hemodialysis access

“…Leszek Sułkowski 1 , Czesław Osuch 2 , Maciej Matyja 2 , Andrzej Matyja 2 The autogenous arteriovenous fistula (AVF) is an access of choice for chronically hemodialyzed patients [1][2][3][4], preferred over central venous catheter placement [5]. The AVF's access vein on the upper extremity can be either the cephalic or basilic vein (BV).…”

“…Therefore, BV AVF remains an access option for difficult cases, along with central venous catheter placement or prosthetic graft AVF [2]. BVTT is technically more complex than catheter placement or prosthetic graft AVF [5,9], but has all the advantages of autogenous AVF and forms a long and superficial vein segment suitable for cannulation [7].…”