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

Pereira, Marta; López, Noelia; Godinho, Iolanda; Jorge, Sofía; Nogueira, Estela; Neves, Fernando; Fortes, Alice; Costa, António Gomes da

doi:10.5935/0101-2800.20170006

Cited by 9 publications

(9 citation statements)

References 12 publications

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“…One report described 7 patients with central and peripheral vein access exhaustion who were not candidates for a tunneled hemodialysis catheter. 10 In this cohort, the mean catheter patency was found to be 8 AE 11 (0-34) months. However, 2 of the 7 patients died due to bleeding and sepsis, and catheter dislodgment was common in the other 5 patients and necessitated reinsertion.…”

mentioning

confidence: 68%

“…Various options for access placement are available in dialysis patients as accesses of last resort. [5][6][7][8][9][10][11][12][13][14][15][16][17] These include trans-lumbar, trans-hepatic, trans-renal, azygous, and hemiazygous vein dialysis catheters. In addition, the HeRO (hemodialysis reliable outflow, Merit Medical Systems) device is also available for dialysis patients as an access of last resort.…”

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confidence: 99%

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Vascular access of last resort

Vachharajani¹,

Agarwal

Asif

2018

Kidney International

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mentioning

confidence: 68%

mentioning

confidence: 99%

Vascular access of last resort

Vachharajani¹,

Agarwal

Asif

2018

Kidney International

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“…The conclusion they draw is that the placement of an intraatrial catheter for HD is associated with significant risk and high mortality. However, when the possibilities for alternative renal replacement therapy are exhausted, this approach must be considered (5).…”

Section: Discussionmentioning

confidence: 99%

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

Manoilov

Panayotov

Petrov

et al. 2020

SSM

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INTRODUCTION:Patients on permanent hemodialysis need constant and secure vascular access with optimal flow to perform the procedure. Failure to provide such access can lead to life-threatening deterioration of the patient's condition. CASE PRESENTATION:We report a case of implantation of a hemodialysis catheter directly in the right atrium (RA) in an emergency in a 46 year-old woman, placed on permanent hemodialysis (HD) for nine years due to end-stage renal disease with exhausted opportunities for vascular access over the years and unsuitable for peritoneal dialysis.After a consultation between a cardiac surgeon, a vascular surgeon and an interventional radiologist, a decision was made to directly implant a permanent catheter for HD in the superior vena cava (SVC).The operation was performed as a matter of urgency, operative access was through ministerotomy and the catheter was implanted directly in the right atrium (RA) due to thrombosis and fibrosis of the SVC. No cardiac complications associated with the procedure were observed in the postoperative period. On the first postoperative day, HD was performed, followed by others according to the therapeutic plan. The patient was discharged from the Cardiac Surgery Department on the 7th postoperative day. CONCLUSION:The use of open surgical access and the implantation of a permanent HD catheter directly into the RA can be considered a life-saving procedure in HD patients with acute uremic syndrome and exhausted vascular access.

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“…Indications for IAC placement of conventional vascular accesses are exhausted, and life-saving situations of multiple venous access failure (1,2). Chavanon et al (3) were the first to report the placement of IAC in 1999.…”

Section: Discussionmentioning

confidence: 99%