Report on an Italian survey of 72 stuck hemodialysis catheters

Forneris, Giacomo; Savio, Daniele; Quaretti, Pietro; Lodi, Massimo; Comelli, Simone; Morale, Walter; Spina, Monica; Maggio, Luca; Cornacchiari, Marina; Punzi, M; Gatta, Gemma; Cecere, Pasqualina; Pozzato, Marco; Marciello, Antonio; Roccatello, Dario

doi:10.1007/s40620-022-01474-y

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…There are limited data available on the safety and long-term outcomes of thoracotomy for stuck haemodialysis catheters. A recently published survey [ 2 ] of 72 stuck haemodialysis catheters across 30 centres in Italy revealed that 11 patients were not subject to advanced procedures, with 3 lines left in situ and the other 8 were buried. There was a 77% success rate for stuck catheters undergoing advanced procedures (47 were removed and 14 were left in situ or buried).…”

Section: Discussionmentioning

confidence: 99%

“…In centers limited by geographic considerations or resources, transfer to an IR-capable facility should be considered along with the patient characteristics prior to internalization. Among the options considered for removal of a stuck catheter, endoluminal sequential balloon dilatation appears to be the best approach [ 2 ]. Nephrologists should be aware of the utility of such techniques and consider its feasibility prior to discussing the best management strategy with the patient.…”

Section: Discussionmentioning

confidence: 99%

“…The incarcerated, hereafter referred to as ‘stuck’, tunnelled-cuffed venous catheter is an uncommon but challenging situation, where the line cannot be removed successfully using standard techniques. Stuck catheters are reported as a complication in around 1% of haemodialysis catheters, but have been reported as high as 20% in lines in situ for over 2 years [ 2 , 3 ]. Attempting removal using excessive force has previously resulted in vessel perforation, right atrial tears, hemopericardium and retained fragments [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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The stuck haemodialysis catheter—a case report of a rare but dreaded complication following kidney transplantation

Burnett,

Chandler,

Jegatheesan

et al. 2024

BMC Nephrol

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Background Tunnelled cuffed haemodialysis catheters are at increased risk of incarceration or becoming ‘stuck’ via fibrotic adhesion to the central veins when left in situ for prolonged periods of time. Stuck catheters cannot be removed using standard techniques such as bedside dissection of the cuff. Whilst there are several strategies published for the removal of these incarcerated lines, there is no consensus on the best approach. Here we present a challenging case of a stuck haemodialysis catheter in the acute post transplantation period. Case Presentation A 66-year-old female on haemodialysis presented for kidney transplantation with a tunnelled-cuffed haemodialysis catheter in situ for five years. Following transplantation, removal of the line was unsuccessful despite dissection of the cuff, with traction causing a choking sensation with tracheal movement. Eventually, the line was removed without complications utilising sequential balloon dilatation by interventional radiology and the patient was discharged without complications. Conclusions This case serves as a timely reminder of the risks of long-term tunnelled haemodialysis catheters and as a caution towards proceeding with kidney transplantation in those with long-term haemodialysis catheters in situ. Greater nephrologist awareness of interventional radiology techniques for this challenging situation will help to avoid more invasive strategies. The risks of a stuck catheter should be included in the discussions about the optimal vascular access and transplantation suitability for a given patient.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The stuck haemodialysis catheter—a case report of a rare but dreaded complication following kidney transplantation

Burnett,

Chandler,

Jegatheesan

et al. 2024

BMC Nephrol

View full text Add to dashboard Cite

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Removal of stuck tunnelled dialysis line requiring cardiopulmonary bypass and venous repair

Bakr,

Ali

2023

J Vasc Access

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Tunnelled central venous dialysis catheters can usually be removed easily. However, their removal can become rarely complicated requiring more invasive techniques. We report a case in which cardiopulmonary bypass and repair of great veins was required for safe removal. A 38-year-old female with end-stage renal failure and a 3-year-old Hickman line inserted into her right internal jugular vein was referred to our cardiac surgical unit following failed attempts of line removal by local vascular surgical team using open vascular surgical techniques. As a result, an MDT decision was made that it was safer to proceed to a cardiothoracic surgical approach rather than other techniques. Investigations showed significant calcification surrounding the line which was adherent to the venous wall. Removal of the retained catheter required median sternotomy and the use of cardiopulmonary bypass as the great veins had to be opened to free the line and allow complete removal. The line was successfully removed with its encircling calcified sheath, and the veins were closed primarily without needing a patch repair. The integrity of the great veins was maintained to meet the on-going need this young patient has for central venous access. The patient made an uneventful recovery. When other measures fail, sternotomy and cardiopulmonary bypass provide a safe option for complete removal of stuck central venous catheters with low risk to the patient.

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Endovascular tools for vascular access stenosis: Flow-chart proposal

Taurisano,

Mancini,

Cortese

et al. 2024

J Vasc Access

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Stenosis represents the most relevant arteriovenous fistula (AVF) pathology and can affects the entire conduit forming the fistula, from afferent artery to central venous vessels. Correction of vascular access stenosis significantly affects the survival and quality of life for end stage renal disease patients (ESRD) dependent on hemodialysis. Guidelines consider the procedure of percutaneous transluminal angioplasty (PTA) relevant for the primary treatment of these lesions with excellent results in restoring AVF immediately at the end of the procedure. From first AVF angioplasty in 1981 to now, wide scientific innovation has led to development of new devices, composed by different materials and technologies, specific for the site and the type of stenosis to be treated, able to manage resistant stenotic lesion and to reduce stenosis recurrences. International guidelines do not clearly specify all treatment possibilities in the individual case. In this review the authors want to provide specific information on most used devices for stenosis treatment based on literature evidence, showing when and where to use the various tools available with flow-chart treatment proposal.

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Report on an Italian survey of 72 stuck hemodialysis catheters

Cited by 3 publications

References 26 publications

The stuck haemodialysis catheter—a case report of a rare but dreaded complication following kidney transplantation

The stuck haemodialysis catheter—a case report of a rare but dreaded complication following kidney transplantation

Removal of stuck tunnelled dialysis line requiring cardiopulmonary bypass and venous repair

Endovascular tools for vascular access stenosis: Flow-chart proposal

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