Dealing with stuck hemodialysis catheter: state of the art and tips for the nephrologist

Abstract

The term stuck catheter refers to the condition in which a catheter is not removable from a central vein using standard techniques. Although it is a rare complication, in the last few years it has been reported ever more frequently in hemodialysis due to the widespread use of tunneled catheters. Poor knowledge of the correct procedures and limited experience and training of the specialist in facing this problem are the main reasons for catheter internalization. Stuck catheter is often diagnosed by the nephrologist who should be competent enough to manage this clinical complication. Among the many options for removing a stuck catheter from the fibrin sleeve, an interventional radiology approach, mainly with endoluminal balloon dilatation, probably provides the best solution. Vascular surgery should be reserved to selected cases in which percutaneous techniques have failed. Nephrologists must play a central role in organizing the treatment of this complication with other specialists in order to avoid making mistakes that may preclude future positive results.

Bedside Tunneled Dialysis Catheter Removal-A Lesson Learned From Nephrology Trainees

“…A recent article reviewed risk factors, recognition and resolution techniques of retained catheters , and similar to ours, emphasized the importance of physicians' training in mobilizing additional resources. Accordingly, retained catheters fixated to the surrounding structures beyond the Dacron cuff may represent a distinct challenge and require endoluminal dilatation , transcatheter extractor device , or laser sheath liberation , depending on institutional experience and are well summarized in recent reviews .…”

Application of Hong’s technique for removal of stuck hemodialysis tunneled catheter to pacemaker leads

“…Endoluminal dilatation is an interventional procedure pioneered by Hong that involves positioning balloons within a catheter, expanding the lumen and stretching the catheter wall. This leads to the disruption of the fibrin sheath and adhesions between the catheter and the vessel [8] , [18] . The technique is straightforward and has been reported to be used successfully without complications in the removal of stuck catheters, mainly single lumen catheters using standard balloons [14] , [19] .…”

Removing the Incarcerated Tunneled Cuffed Venous Catheters: An Experience from a Single Center

“…However, in the event of the catheter getting stuck, then removing it becomes difficult or even impossible sometimes. The occurrence rate of stuck tCVCs is 1.5-19% [1][2][3][4]. The pathogeneses of tCVCs incarceration are complicated, including the cumulative indwelling time as the most important risk factor [2], vessel calcification, repeated catheter-related infections, vascular curvature of cannulation site, and the fibrin sheath of tCVCs.…”