Interventions for treating central venous haemodialysis catheter malfunction

Kennard, Alice; Walters, Giles; Jiang, Simon; Talaulikar, Girish

doi:10.1002/14651858.cd011953.pub2

Cited by 15 publications

(20 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…13 Mechanical therapy includes transfemoral percutaneous intravascular stripping techniques or sheath disruption via balloon catheter, followed by catheter exchange. 10,[14][15][16] In cancer patients with CVCs, fibrin sheaths and CRTs are common incidental findings in computed tomography (CT) scans performed for oncologic follow-up. To date, there are no standard treatment guidelines available for the management of incidentally found fibrin sheaths and CRTs in asymptomatic patients.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Follow-Up and Clinical Relevance of Incidental Findings of Fibrin Sheath and Thrombosis on Computed Tomography Scans of Cancer Patients with Port Catheters

Lichtenstein

Mammadov

Rau

et al. 2021

TCRM

View full text Add to dashboard Cite

Purpose This retrospective study examined the incidence, progression, and clinical relevance of catheter-related thrombosis (CRT) and/or fibrin sheaths presenting as incidental findings on routine staging computed tomography (CT) scans performed in cancer patients. Patients and Methods Patients who underwent central venous port catheter (CVC) placement in a tertiary care hospital between September 2010 and August 2013 were followed up for up to five years. Two radiologists assessed the presence of fibrin sheath and thrombosis in consensus in staging CT scan. Patient demographics, type of cancer, preoperative comorbidities, date of CVC placement and CTs, preexisting anticoagulation, as well as the type and treatment of catheter-related complications were determined from the electronic medical record. Results A total of 194 patients with 530 CT scans and a mean follow-up time of 394 days were included. Fibrin sheaths and thromboses were seen on 46 scans (8.7%) in 30 patients and 80 scans (15.1%) in 35 patients. The incidence of fibrin sheaths and thromboses was found to be 15.5% and 18%, respectively. The comparison to initial CT reports results indicated that fibrin sheaths or thromboses were missed in 106 examinations (20%). Catheter-associated complications were reported in 14 patients (21.5%) without specific therapy. Conclusion Fibrin sheaths and CRTs are often overlooked on routine CT scans when patients are asymptomatic. The subsequent high complication rate demonstrates the clinical relevance of the initial incidental finding on CT scan. Further studies should elucidate the effect of thrombolytic agents and interventional radiologic treatment in asymptomatic patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Long-Term Follow-Up and Clinical Relevance of Incidental Findings of Fibrin Sheath and Thrombosis on Computed Tomography Scans of Cancer Patients with Port Catheters

Lichtenstein

Mammadov

Rau

et al. 2021

TCRM

View full text Add to dashboard Cite

show abstract

“…As a result, several open surgical and endovascular procedures have been developed to maintain failing AV accesses. The most common is plain old balloon angioplasty (POBA), but post-intervention failure remains common [ 5 ]. This high failure rate prompted new technological developments intended to improve treatment effectiveness such as specialized cutting balloons and drug-eluting balloons [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of secondary procedures for maintaining arteriovenous hemodialysis access patency: protocol for a systematic review and network meta-analysis

et al. 2020

View full text Add to dashboard Cite

Background: Arteriovenous (AV) hemodialysis access creation is recommended by international guidelines as the preferred method of hemodialysis access. However, most AV access sites will require revision to maintain patency. Although several treatment options exist, many have not been directly compared. We intend to compare the relative effectiveness of methods to maintain post-intervention primary patency of failing AV access. Methods: We will search EMBASE, MEDLINE, CENTRAL, trial registries, the grey literature, and ancestry and citation search from January 1977 to present, for randomized controlled trials comparing interventions to maintain primary patency of AV access. Two investigators will independently and blindly review all identified citations and extract data from included studies. The primary outcome is the primary patency 6 months after intervention. Secondary outcomes include immediate technical and functional success, reinterventions, patency, and mortality. Risk of bias, subgroup analyses, and sensitivity analyses are planned. Discussion: There are a number of treatment modalities for the management of failing AV access. However, most modalities have only been directly compared with plain old balloon angioplasty, and currently synthesized evidence focuses on individual pairwise comparisons. In light of the lack of comprehensively synthesized evidence and clinical equipoise, our study intends to synthesize currently available evidence though it is unclear which treatment modality is most effective.

show abstract

“…The technique of inflating an angioplasty balloon within the dialysis catheter over an intraluminal wire for fibrin sheath disruption prior to removal/exchange is well described in the literature [2, 3]. Indeed case reports have been performed inflating a balloon within the catheter lumen to dislodge a fibrin sheath surrounding a line prior to catheter removal [4–8].…”

Section: Introductionmentioning

confidence: 99%

TuLIP (Tunnelled Line Intraluminal Plasty): An Alternative Technique for Salvaging Haemodialysis Catheter Patency in Fibrin Sheath Formation

Chapman

Tantrige

Hussain

et al. 2019

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

BackgroundRenal patients with a tunnelled haemodialysis line are at risk of fibrin ‘sheath’ formation which can lead to occlusion. Dysfunctional lines are best treated by catheter exchange with a new subcutaneous tunnel; however, there is a risk of scarring, venous stenosis, potential loss of valuable access as well as the risk of infection.MethodWe report a retrospective review of our experience using tunnelled line intraluminal plasty (TuLIP) in 11 patients over 16 months with fibrin sheath formation on pre-existing tunnelled haemodialysis catheters.ResultAll patients responded well to treatment with median line patency post TuLIP reaching 112 days.ConclusionTuLIP may have a role in extending catheter lifespan and delaying more invasive intervention.

show abstract

Interventions for treating central venous haemodialysis catheter malfunction

Cited by 15 publications

References 65 publications

Long-Term Follow-Up and Clinical Relevance of Incidental Findings of Fibrin Sheath and Thrombosis on Computed Tomography Scans of Cancer Patients with Port Catheters

Long-Term Follow-Up and Clinical Relevance of Incidental Findings of Fibrin Sheath and Thrombosis on Computed Tomography Scans of Cancer Patients with Port Catheters

Efficacy and safety of secondary procedures for maintaining arteriovenous hemodialysis access patency: protocol for a systematic review and network meta-analysis

TuLIP (Tunnelled Line Intraluminal Plasty): An Alternative Technique for Salvaging Haemodialysis Catheter Patency in Fibrin Sheath Formation

Contact Info

Product

Resources

About