Fibrin Sheath Stripping versus Catheter Exchange for the Treatment of Failed Tunneled Hemodialysis Catheters: Randomized Clinical Trial

Merport, Michael; Murphy, Timothy P.; Egglin, Thomas K.; Dubel, Gregory J.

doi:10.1016/s1051-0443(07)61351-7

Cited by 95 publications

(52 citation statements)

References 11 publications

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“…A randomized study found that fibrin sheath stripping was comparable to urokinase infusion for management of malfunctioning dialysis catheters in terms of primary patency (104). A second randomized study observed superior primary patency after catheter exchange, as compared with fibrin sheath stripping (105). Dysfunction is more common in femoral catheters than in internal jugular vein catheters (106).…”

Section: Treatment Of Catheter Thrombosis or Malfunctionmentioning

confidence: 99%

Current Management of Vascular Access

Allon¹

2007

Clinical Journal of the American Society of Nephrology

245

231

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Optimizing vascular access outcomes remains an ongoing challenge for clinical nephrologists. All other things being equal, fistulas are preferred over grafts, and grafts are preferred over catheters. Mature fistulas have better longevity and require fewer interventions, as compared with mature grafts. The major hurdle to increasing fistula use is the high rate of failure to mature of newly created fistulas. There is a desperate need for enhanced understanding of the mechanisms of failure to mature and the optimal type and timing of interventions to promote maturity. Grafts are prone to frequent stenosis and thrombosis. Surveillance for graft stenosis with preemptive angioplasty may reduce graft thrombosis, but recent randomized clinical trials have questioned the efficacy of this approach. Graft stenosis results from aggressive neointimal hyperplasia, and pharmacologic approaches to slowing this process are being investigated in clinical trials. Catheters are prone to frequent thrombosis and infection. The optimal management of catheter-related bacteremia is a subject of ongoing debate. Prophylaxis of catheter-related bacteremia continues to generate important clinical research. Close collaboration among nephrologists, surgeons, radiologists, and the dialysis staff is required to optimize vascular access outcomes and can be expedited by having a dedicated access coordinator to streamline the process. The goal of this review is to provide an update on the current status of vascular access management.

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Section: Treatment Of Catheter Thrombosis or Malfunctionmentioning

confidence: 99%

Current Management of Vascular Access

Allon¹

2007

Clinical Journal of the American Society of Nephrology

245

231

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“…These are known to manifest as a persistent withdrawal occlusion despite having an intact injection of fluid. Endovascular stripping using a snare device is commonly performed to break down the fibrin sheath, but recurrence of the fibrin sheath is also common (16)(17)(18). In our study, fibrin sheath stripping was performed in 7 out of 15 patients with fibrin sheath formations.…”

Section: Discussionmentioning

confidence: 95%

Malfunction of Totally Implantable Central Venous Ports

2016

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“…However, it is important to note that not all patients had contrast injected to diagnose this. Catheter sheaths may be disrupted by infusion of thrombolytic therapy, stripping, and disruption during guide wire exchange (34,35). In our center, angioplasty balloon sheath disruption has been used to maintain the access once fibrin sheath was identified by angiography.…”

Section: Discussionmentioning

confidence: 99%

Patency and Complications of Translumbar Dialysis Catheters

2014

American Journal of Kidney Diseases

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Fibrin Sheath Stripping versus Catheter Exchange for the Treatment of Failed Tunneled Hemodialysis Catheters: Randomized Clinical Trial

Cited by 95 publications

References 11 publications

Current Management of Vascular Access

Current Management of Vascular Access

Malfunction of Totally Implantable Central Venous Ports

Patency and Complications of Translumbar Dialysis Catheters

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