Studying alternative approaches for placement of cuffed hemodialysis catheters in hemodialysis patients with bilateral internal jugular vein occlusion

Abstract

End-stage renal disease patients maintained on regular hemodialysis who have bilateral internal jugular vein obstruction and non-functioning arteriovenous fistula/graft is a daily scenario in nephrology practice. Our study showed that there is a variety of approaches for the insertion of cuffed hemodialysis catheters other than occluded internal jugular veins. Interventional nephrologists have a major role in solving the problem of poor hemodialysis vascular access. These alternative approaches can conserve the anatomically limited number of percutaneous access sites in each patient.

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“…However, no reference is made to other complications such as infection, bleeding, hematoma, etc. 22 As it turned out in our research, utilization of this tool helps shorten the time required for catheter removal compared to usual methods. This tool will also reduce bleeding significantly compared to common methods.…”

“…Causing damage to surrounding arteries, thrombosis and blood clotting, arterial rupture and bacterial infections are some of these complications. The most important type of infection is Staphylococcus aureus 20,21,22 . As we observed in the present research, using the new method of catheter removal has significant differences with old methods concerning catheter removal time, bleeding level, and the number of stitches required.…”

Carotid artery tortuosity may pose a problem during insertion of the tunneled catheter for hemodialysis

“…Naturally, insertion of CVC in such conditions may exacerbate the abovementioned symptoms. In recognized symptomatic IJVS cases, a physician should consider an alternative vascular access 17 . In asymptomatic patients, the decision to insert should be made by the physician based on the risk of harming the artery and venipuncture difficulty (Figure 4).…”

Trans-cells of stent hemodialysis catheter placement in patients with exhausted cen-tral venous access

“…El agotamiento de accesos es una situación terminal. Admite (con el fin mayor de prolongar la supervivencia de estos pacientes) realizar maniobras extremas [5][6][7] .…”