Use of Unconventional Dialysis Access in Patients With No Viable Alternative

Herscu, Gabriel; Woo, Karen; Rowe, Vincent L.

doi:10.1016/j.avsg.2012.04.019

Cited by 21 publications

(11 citation statements)

References 11 publications

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“…Conventional tunnelled catheters are discussed in Chapter 3 (3.3.4). Despite the clear evidence that tcCVCs should be avoided by achieving a timely autogenous VA, there remain a significant number of patients who require placement of complex high risk salvage lines such as trans-lumbar, transhepatic 630,642 lines and lines through the parenchyma of a failed renal allograft or the native kidney to access the IVC. 643 The morbidity and mortality of complex line insertions and their short-term benefit would suggest that they should only be used after all other options, including complex grafts and PD have been ruled out.…”

Section: Complex Central Venous Cathetersmentioning

confidence: 99%

Editor's Choice – Vascular Access: 2018 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Schmidli¹,

Widmer²,

Basile³

et al. 2018

European Journal of Vascular and Endovascular Surgery

594

622

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Section: Complex Central Venous Cathetersmentioning

confidence: 99%

Editor's Choice – Vascular Access: 2018 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

Schmidli¹,

Widmer²,

Basile³

et al. 2018

European Journal of Vascular and Endovascular Surgery

594

622

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“…In those with details, the rate was between 5.1% and 23.8% (pooled = 15 dislodgements in 147 catheters = 10.2%). 18,25,26,28 Infection rates were reported by Liu et al 24 as catheterrelated infection in 36% with catheter-related bacteraemia (CRB) as 31% and site infection as 5%. When reported as per catheter-related days (crd), the rate is 4/100 crd.…”

Section: Resultsmentioning

confidence: 99%

“…Translumbar/transhepatic catheters Published reports from 1995 to 2018 are summarised in Table 1. [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] The age range of patients in these reports is from 22 to 83 with a mean age cited between 42 and 61.9 years.…”

Section: Resultsmentioning

confidence: 99%

Options for end stage vascular access: Translumbar catheter, arterial-arterial access or right atrial graft?

et al. 2019

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Background: Running out of vascular access for dialysis is thankfully rare, but despite this, most units will have a number of patients with few options and in a precarious state. The increasing longevity of dialysis patients portends more patients will reach minimal access options. End stage vascular access is poorly defined but classification may enable assessment and comparison of treatment options. Three options for patients with end stage access are a central venous catheter through a translumbar or transhepatic route, arterial-arterial prosthetic loop or a right atrial graft. Aims: The aims of this study are to provide a structured review of evidence for these procedures to allow application and guide practice for patients with end stage vascular access. Methods: A standardised search of published literature was performed of relevant studies. In addition, the references cited in those papers were assessed for any further available articles. All study types were included and reviewed by two authors independently. Primary outcomes were patient survival and secondary patency rate at 3 and 12 months. Secondary outcomes were long-term patency rates, mean time to cannulation and complications such as access dysfunction, thrombosis and infection. Summary: Based on the available evidence, it would appear that arterial-arterial prosthetic loop is a definitive option for maintaining dialysis access in patients with no more arteriovenous access options. Translumbar and transhepatic dialysis catheters may offer short- and medium-term options and right atrial grafts may also be suitable as an option where arterial-arterial prosthetic loop is unsuitable.

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“…There are 3 smaller studies assessing transhepatic central venous catheters, with shorter follow-up periods or not limited to translumbar catheters. 91 , 92 , 94 …”

Section: Last Access Optionsmentioning

confidence: 99%