Front-Loading a Peritoneal Dialysis Catheter Prevents Its Migration in Elderly Patients

Dantoine, Thierry; Benevent, D.; Boudet, Rémi; Lagarde, C; Charmes, Jean-Pierre; Leroux-Robert, C.

doi:10.1177/089686080202200417

Cited by 3 publications

(2 citation statements)

References 16 publications

(22 reference statements)

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“…The tungsten loaded or "self locating" catheter has a small titanium weight incorporated in the catheter tip (16)(17)(18); a similar modification placing a stainless steel weight on the outside of the intraperitoneal catheter tip has been used to repair poorly draining catheters exhibiting migration (19). Limited early reporting suggests that these designs reduce catheter migration and early outflow failure, but the safety of intraperitoneal modification is yet undetermined.…”

Section: Catheter Configurationmentioning

confidence: 99%

Peritoneal Catheters and Exit-Site Practices toward Optimum Peritoneal Access: A Review of Current Developments

2005

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Objective This review updates the 1998 International Society for Peritoneal Dialysis (ISPD) recommendations for peritoneal dialysis catheters and exit-site practices (Gokal R, et al. Peritoneal catheters and exit-site practices toward optimum peritoneal access: 1998 update. Perit Dial Int 1998; 18:11–33.) Design Data Sources: The Ovid and PubMed search engines were used to review the Medline databases of January 1980 through June 2003. Searches were restricted to human data; primary key word searches included dialysis, peritoneal dialysis, and continuous ambulatory peritoneal dialysis cross referenced with access, catheter, dialysis catheter, peritoneal dialysis catheter, and Tenckhoff catheter. Related searches were provided via the PubMed related articles link. Study Selection: Reports were selected if they provided identifiable information on catheter design, catheter placement technique, and survival or placement complications. Reports without such data were excluded from review. Each study was then categorized by its characteristics: single-center or multicenter; retrospective or prospective; controlled trial, with or without random patient assignment; or review article. Main Results There are few randomized controlled evaluations testing how catheter design and/or placement influence long-term survival and function, and these are typically conducted at a single center. The majority of reports represent retrospective single-center experiences, and these are supplemented by occasional multicenter data registries. Conclusions There is substantial variability in catheter outcomes between centers, and this variability is more closely correlated with operator and center characteristics than with catheter design. Some catheter designs appear to impact long-term catheter success, and, in some cases, specific patient characteristics and dialysis formats combine with specific catheter designs to influence catheter survival. Most reporters prefer two-cuff designs and placement of the deep cuff at an intramuscular location. Intramuscular cuff placement results in fewer pericatheter leaks and hernias, but makes catheter removal more difficult. High-risk patients (those with previous pelvic surgery) benefit from visual inspection of the peritoneum during catheter placement, and in randomized controlled trials, catheters with pre-shaped arcuate subcutaneous segments (“swan neck” designs) reduce the risk of early drainage failure via “migration.”

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Section: Catheter Configurationmentioning

confidence: 99%

Peritoneal Catheters and Exit-Site Practices toward Optimum Peritoneal Access: A Review of Current Developments

2005

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“…Bien qu'il y ait plusieurs techniques de repositionnement du cathéter dans le petit bassin, celles-ci ne sont pas toujours concluantes à court, à moyen ou à long terme. Vers 1997, il a été mis au point en Limousin un lest en acier inoxydable, placé à l'extrémité intra-péritonéale du cathéter afin d'éviter un déplacement de celui-ci dans l'abdomen (1). Nous avons réalisé une étude rétrospective sur les patients ayant bénéficié d'un tel traitement afin de déterminer l'efficacité de ce système de lestage en termes de récidive de migration et de sécurité d'utilisation.…”

Section: Introductionunclassified

Efficiency and safety of using a peritoneal dialysis catheter weighted with a stainless steel ballast : the Limousin experience

Larivière-Durgueil¹,

Boudet²,

Essig³

et al. 2019

Bull Dial Domic

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Objective: To assess the recurrence of PD catheter migration after the introduction of a walnut ballast. Materials and Methods: Retrospective study from 1999 to 2014 of PD patients followed in Limousin. Were compared two groups: ballast group (patients who benefited from the establishment of stainless steel ballast at the intraperitoneal catheter extremity) with 26 patients and control group with 204 patients. The primary endpoint was the occurrence of an episode catheter’s migration after ballast’s establishment. Secondary objectives were (i) to determine the causal factors leading to the catheter weighting, (ii) to ensure the safety of the procedure on the following criteria: infectious complications, mechanicals complications, epurations criteria, and catheter’s survival. Results: More than one year after the implementation of the ballast, no recurrent migration was observed in 86.6% of cases. It wasn’t found an increased risk of infections (OR = 0.5, 95% CI [0.22, 1.13]) or mechanical complications (OR = 1.77- 95% CI [0.77, 4.05]) between the two groups. The adequation criteria were similar: KT / V total : 2.37 in the control group and 2.28 in the ballast group (p = 0.63). The survival of the ballast catheter was comparable among the two groups (p = 0.983). Three causal factors that led to the ballast were identified: automated peritoneal dialysis (APD) (OR = 0.38, 95% CI [0.16, 0.9]), the failure from the first use of the catheter (OR = 19.48, CI 95 % [7.67, 49.48]) and the incarceration of the omentum (OR = 15.84, 95% CI [5.81, 43.21]). Conclusion: The ballast used in these study appears to prevent recurrence of migration, without any impact in terms of infectious or mechanical complications, or on the dialysis criteria or on catheter’s survival. However this catheter does currently not have an EC authorization

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Complications of Peritoneal Dialysis Catheters: Early and Late

2006

Int J Artif Organs

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The complications of peritoneal dialysis catheters are often due to errors made during the initial catheter insertion procedure. Other complications relate to the improper selection of the catheter type or size. Thus, many complications are preventable. This review summarizes the complications resulting from the insertion or presence of a PD catheter and classifies them as either early or late events. A short comment on early diagnosis and appropriate management is also provided.

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Front-Loading a Peritoneal Dialysis Catheter Prevents Its Migration in Elderly Patients

Cited by 3 publications

References 16 publications

Peritoneal Catheters and Exit-Site Practices toward Optimum Peritoneal Access: A Review of Current Developments

Peritoneal Catheters and Exit-Site Practices toward Optimum Peritoneal Access: A Review of Current Developments

Efficiency and safety of using a peritoneal dialysis catheter weighted with a stainless steel ballast : the Limousin experience

Complications of Peritoneal Dialysis Catheters: Early and Late

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