New Method of Forced Implantation of Permanent Catheters for Hemodialysis into Critically Stenosed or Occluded Central Veins

• Authors: Stanisław Przywara , Marek Iłżecki , Piotr Terlecki , Tomasz Zubilewicz
• Languages of publication: EN

Abstracts

EN

The aim of the study was to report a novel technique of forced implantation of catheters for hemodialysis into critically stenosed or occluded central veins, without preceding angioplasty or stenting.Material and methods. Sixteen patients with central venous occlusive disease, requiring urgent hemodialysis underwent this procedure. Catheterization of stenosis - occlusion was initially performed with soft guidewire, subsequently exchanged to stiff guidewire. Forced insertion of dilators, peel-off sheath throughout the stenosis or occlusion and finally implantation of the catheter completed the procedure. Our technique does not require pre-procedural angioplasty or stent deployment.Results. In all patients postoperative hemodialysis was managed with satisfactory adequacy. No early or late complications related to the procedure occurred. We did not observe any clinically significant aggravation of symptoms of central vein stenosis or occlusion. Complications, not-related to the procedure included one, late skin entry site infection and one, late catheter thrombosis. These were managed without the necessity of catheter exchange.Conclusions. Our technique of forced implantation of catheters for hemodialysis into critically stenosed or occluded central veins without previous balloon predilatation or stenting is simple and diminishes the total cost of the procedure. Provides quick vascular access for hemodialysis in life threatening situations.

Keywords

EN

vascular access for hemodialysis; permanent catheters for hemodialysis; central venous occlusive disease

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2015
• Volume: 86
• Issue: 9
• Pages: 405-409

Dates

online

18 - 12 - 2014

received

29 - 6 - 2014

Contributors

author

Stanisław Przywara

• Department of Vascular Surgery and Angiology, Medical University in Lublin Kierownik: dr hab. prof. nadzw. UM

author

Marek Iłżecki

• Department of Vascular Surgery and Angiology, Medical University in Lublin Kierownik: dr hab. prof. nadzw. UM

author

Piotr Terlecki

• Department of Vascular Surgery and Angiology, Medical University in Lublin Kierownik: dr hab. prof. nadzw. UM

author

Tomasz Zubilewicz

• Department of Vascular Surgery and Angiology, Medical University in Lublin Kierownik: dr hab. prof. nadzw. UM

References

• 1. Agarwal AK, Patel Bm, Haddad NJ: Central vein stenosis: a nephrologist's perspective. Semin Dial 2007; 20(1): 53-62.[Crossref][WoS]
• 2. Barrett N, Spencer S, Mcivor J et al.: Subclavian stenosis: a major complication of subclavian dialysis catheters. nephrol Dial transplant 1988; 3: 423-25.
• 3. Schillinger F, Schillinger D, Montagnac r et al.: Post catheterisation venous stenosis in haemodia-lysis: comparative angiographic study of 50 subc-lavian and 50 internal jugular accesses. nephrol Dial transplant 1991; 6: 722-24.
• 4. NKF-K/DOQI clinical practice guidelines for vascular Access 2000. Guideline 20. am J kidney Dis 2001; 37: 137-81.
• 5. Gray RJ, Dolmatch BL, Buick MK: Directional atherectomy treatment for hemodialysis access: early results. J Vasc interv radiol 1992; 3: 497-03.[PubMed][Crossref]
• 6. Gradman wS, bressman P, Sernaque JD: Sub-clavian vein repair in patients with an ipsilateral arteriovenous fstula. ann Vasc Surg 1994; 8: 549-56.[Crossref]
• 7. Puskas JD, Gertler JP: Internal jugular to axil-lary vein bypass for subclavian vein thrombosis in the setting of brachial arteriovenous fstula. J Vasc Surg 1994; 19: 939-42.[Crossref]
• 8. El-Sabrout Ra, Duncan JM: Right atrial bypass grafting for central venous obstruction associated with dialysis access: another treatment option. J Vasc Surg 1999; 29: 472-78.[Crossref][PubMed]
• 9. Beathard Ga: Percutaneous transvenous angio plasty in the treatment of vascular access stenosis. kidney int 1992; 42: 1390-97.[Crossref]
• 10. Lumsden Ab, MacDonald MJ, Isiklar H et al.: Central venous stenosis in the hemodialysis patient: incidence and effcacy of endovascular treatment. cardiovasc Surg 1997; 5: 504-09.[Crossref]
• 11. Buriánková E, Köcher M, Bachleda P et al.: Endovascular treatment of central venous stenoses in patients with dialysis shunts. biomed Pap Med Fac univ Palacky olomouc czech repub 2003; 147(2): 203-6.[Crossref]
• 12. Asif A, Salman L, Carrillo Rg et al.: Patency rates for angioplasty in the treatment of pacema-ker-induced central venous stenosis in hemodialysis patients: results of a multi-center study. Semin Dial 2009; 22(6): 671-76.[WoS][Crossref]
• 13. Greenberg JI, Suliman A, Angle N: Endovascu-lar dialysis interventions in the era of DOQI. ann Vasc Surg 2008; 22(5): 657-62.[WoS][Crossref]
• 14. Maya ID, Saddekni S, Allon M: Treatment of refractory central vein stenosis in hemodialysis patients with stents. Semin Dial 2007; 20(1): 78-82.[Crossref][WoS][PubMed]
• 15. Waksman R, Crocker IR: Radiation for prevention of restenosis: where are we? int J radiat oncol biol Phys 1996; 36(4): 959-61.[PubMed][Crossref]
• 16. Anaya-Ayala JE, Smolock CJ, Colvard BD et al.: Effcacy of covered stent placement for central venous occlusive disease in hemodialysis patients. J Vasc Surg 2011; 54(3): 754-59.[Crossref]
• 17. Jones Rg, Willis Ap, Jones C et al.: Long-term results of stent-graft placement to treat central venous stenosis and occlusion in hemodialysis patients with arteriovenous fstulas. J Vasc interv radiol 2011; 22(9): 1240-45.[Crossref]
• 18. Chang CJ, KO PJ, Hsu La et al.: Highly increased cell proliferation activity in the restenotic hemodialysis vascular access after percutaneous translumi-nal angioplasty: implication in prevention of reste-nosis. am J kidney Dis 2004; 43(1): 74-84.[Crossref]
• 19. Levit Rd, Cohen Rm, Kwak A et al.: Asympto-matic central venous stenosis in hemodialysis patients. radiology 2006; 238(3): 1051-56.[Crossref]
• 20. Davidson Cj, Newman Ge, Sheikh Kh et al.: Mechanisms of angioplasty in hemodialysis fstula stenoses evaluated by intravascular ultrasound. kidney int 1991; 40(1): 91-95.[Crossref]
• 21. Misty M. Payne: Charles Theodore Dotter: The Father of Intervention. tex Heart inst J 2001; 28(1): 28-38.
• 22. Wallace JR, Chaer RA, Dillavou ED: Report on the Hemodialysis Reliable Outfow (HeRO) experience in dialysis patients with central venous occlusions. J Vasc Surg 2013 Sep; 58(3): 742-47.[Crossref][WoS]

Identifiers

DOI

10.2478/pjs-2014-0072