Transhepatic PermCath for Hemodialysis

Po, Christopher L.; Koolpe, Harvey A.; Allen, Steven R.; Alvez, Laura D.; Raja, Rasib M.

doi:10.1016/s0272-6386(12)80218-6

Cited by 63 publications

(27 citation statements)

References 4 publications

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“…Furthermore, translumbar catheter revisions are more difficult because of a risk of retroperitoneal fibrosis. Po et al (9) applied transhepatic catheterization in an adult patient for the first time in 1994, and since then, it has become an alternative access route in cases that are dependent on chronic hemodialysis and have inaccessible central venous routes. The procedure is technically relatively simple for interventional radiologists and can be successfully applied because of their experiences in biliary drainage and tunneled catheter placement through different peripheral veins (3).…”

Section: Discussionmentioning

confidence: 99%

“…Migration was the most frequent complication in the series of Younes et al (4) with 22 patients and 127 catheters; the reason for this could be due to using multiple catheters for short periods. The transhepatic route was initially suggested to be used for a short time only and transiently until ensuring the maturity of other venous access routes (9). It was used as a transient route in the series of Smith et al (3) before AV grafting in three patients and subcutaneous port placement in two patients, and in the series of Younes et al (4) before AV fistula opening in four patients and peritoneal dialysis in two patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Safety and functionality of transhepatic hemodialysis catheters in chronic hemodialysis patients

Şanal

Nas²,

Doğan³

et al. 2016

Diagn Interv Radiol

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T he main central venous routes used in chronic hemodialysis patients with insufficient arteriovenous (AV) fistulas and graft failure are the jugular, subclavian, and femoral veins. Repeated interventions and chronic thrombosis, stenosis, and occlusions secondary to long-term catheterizations can make the use of these veins impossible over years (1,2). Alternative routes are lifesaving in these cases, and the principle routes are the translumbar inferior vena cava (IVC) and transhepatic veins (2-5).The use of the translumbar route is more widespread, its efficiency and safety are well known, and the experience in using this method has already been reported in the literature (5-8). Hepatic vein and IVC catheterization through the transhepatic route is a comparatively more up-to-date method than the one through the translumbar route, and there is only limited experience in using this method. Its success and complication rates were first described by Po et al. (9) in 1994 in one case, and this method was further scrutinized in three retrospective studies comprising 12, 16, and 22 adult patients in the following years (2-4).The aim of this retrospective study was to investigate the safety and functionality of transhepatic hemodialysis catheters in a series of 38 patients. Methods PatientsThe study was approved by the local ethics committee. Thirty-eight transhepatic tunneled hemodialysis catheter implanted patients (mean age 58±11 years; range, 23-80 years; I N T E R V E N T I O N A L R A D I O LO G Y O R I G I N A L A R T I C L E PURPOSEWe aimed to investigate the safety and functionality of tunneled transhepatic hemodialysis catheters in chronic hemodialysis patients. METHODSThirty-eight patients (20 women aged 56±10 years and 18 men aged 61±11 years) with transhepatic tunneled hemodialysis catheters were evaluated. The date of the first transhepatic catheterization, indications, procedure details, functional time periods of catheters, reasons for the removal or revision of catheters, catheter-related complications, and current conditions of patients were retrospectively analyzed. RESULTSA total of 69 catheters were properly placed in all patients (100% technical success) under imaging guidance during the 91-month follow-up period. The functionality of 35 catheters could not be evaluated: five catheters were removed because of noncomplication related reasons (surgical fistulas were opened in two cases [2/35, 5.7%], transplantation was performed in three cases [3/35, 8.6%]), 18 patients died while their catheters were functional (18/35, 51.4%), and 12 catheters were still functional at the time of the study (12/35, 34.3%). The functionality of catheters was evaluated the remaining 34 catheters that necessitated revision because of complications. Furthermore, only half of the catheters were functional on day 136 when evaluated using Kaplan-Meier analysis. The four main complications were thrombosis (16/34, 47%; complication rate of 0.37 days in 100 catheters), infection (8/34, 23.5%; 0.18 days in 100 catheters), m...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Safety and functionality of transhepatic hemodialysis catheters in chronic hemodialysis patients

Şanal

Nas²,

Doğan³

et al. 2016

Diagn Interv Radiol

View full text Add to dashboard Cite

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“…[4][5][6][7][8][9][10] When there is central vein occlusion of the lower and upper limbs, optional accesses are translumbar, 3,4 transhepatic, 4-6,8 transrenal 7 and transazygos. 4 Transhepatic access was described in 1994 by Po et al 10 Since then, some series have been published with small number of cases using that access. Incidence of primary success and infection are equal to those reported in other accesses.…”

Section: Introductionmentioning

confidence: 99%

Relato de caso: implante transparietohepático de cateter de longa permanência para diálise

et al. 2007

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Transhepatic insertion of long-term dialysis catheter is an exception procedure used to obtain access in patients with central vein occlusion of lower and upper limbs. We report on a case of a young patient with history of dialysis for 15 years, who was submitted to an unsuccessful renal transplantation. This patient was in dialytic emergency and had confirmed occlusion of upper limb central veins and iliac veins. Transhepatic insertion of a long-term catheter was performed under general anesthesia. The catheter tip was placed at the level of the right atrium. Dialysis was satisfactorily performed on the same day.Keywords: Transhepatic insertion, hemodialysis, access. RESUMOO implante transhepático de cateteres de diálise de longa permanência é um procedimento de exceção, utilizado para obter um acesso em pacientes com oclusão de veias centrais de membros superiores e inferiores. O caso descrito relata um paciente jovem, com história de 15 anos de diálise, que foi submetido no passado a um transplante renal sem sucesso. Esse paciente encontrava-se em urgência dialítica e oclusão comprovada de veias centrais de membros superiores e de veias ilíacas. Foi realizado o implante do cateter de longa permanência pelo acesso transparietohepático sob anestesia geral. A ponta do cateter foi posicionada ao nível do átrio direito. A diálise foi realizada satisfatoriamente no mesmo dia.Palavras-chave: Implante transhepático, hemodiálise, acesso.

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“…tarafından ilk kez tek bir olguda tarif edildikten sonra, sonuçları birkaç küçük seride analiz edilmiştir. [4][5][6][7] Biz bu çalışmada transhepatik yolla kalıcı hemodiyaliz kateteri yerleştirdiğimiz olgulardaki sonuç-ları, işlemin güvenilirliği ve kateterlerin işlevselliği açısından geriye dönük analiz etmeyi amaçladık.…”

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