Successful removal of stuck and infected haemodialysis catheter via endoluminal balloon dilatation after unsuccessful surgical cut‐down

Abstract

We describe a case of successful removal of an adherent dialysis catheter after an unsuccessful attempt with surgical cut down on the internal jugular vein. A 57-year-old female on maintenance haemodialysis via a left internal jugular tunnelled catheter (Hemoglide, BARD) had an attempted removal of her 17-month-old line after a leak was noted at the catheter hub. By this stage, she had just commenced full cannulation of a left brachiobasilic fistula which had been slow to mature. She had coincidentally been admitted to hospital 2 days prior for treatment of a urinary tract infection from which she was recovering.Under sterile conditions and local anaesthetic, an incision was made in the tract, and the cuff was easily mobilised. The line was transected at the cuff, and the distal segment discarded. The clamped proximal segment was then withdrawn 3 to 4 cm. At this stage, despite moderate traction, the line appeared adherent at the clavicle. After surgical consultation, a CT venogram was requested that appeared to show scarring around the internal jugular vein. With the line clamped (but exposed), she proceeded to theatre the