Metin ONARAN, Şevki SERT, Baran ÖNAL, Koray AKKAN, Erhan T. ILGIT, Figen EKSERT

Tünelli hemodiyaliz kateterlerinin girişimsel radyolojik yöntemle ultrasonografi ve floroskopi kılavuzluğunda yerleştirilmesi: 152 olgunun değerlendirilmesi

Amaç: Ultrasonografı ve floroskopi kılavuzluğunda internal juguler venaracılığıiletakılantünellihemodiyalizkateterlerinin teknik başarı, komplikasyonlar,malpozisyon ve disfonksiyon açısından değerlendirilmesi. Gereç ve Yöntem: Ocak 2003-Nisan 2005 tarihleri arasında, girişimsel radyoloji biriminde sağ ya da sol internal juguler ven aracılığı ile ultrasonografı ve floroskopi kılavuzluğunda 152 tünelli, kalıcı, hemodiyaliz kateteri yerleştirildi. Tüm olgular retrospektif olarak teknik başarı, komplikasyonlar, kateter malpozisyonu ve disfonksiyonu açısından değerlendirildi. Bulgular: Tüm kateterler başarı ile yerleştirildi (teknik başarı oranı; %100). Pnömotoraks ya da arteryel ponksiyona bağlı hetnatom ya da psödoanevrizma gözlenmedi. Tüm kateterlere uçları atriyokaval bileşkede olacak şekilde düzgün pozisyon verildi. Sekiz hastada internal juguler ven girişimi lokalizasyonunda kateterde katlantı görüldü ve katlantılar kateter yerleştirme işlemi tamamlanmadan düzeltildi. Sonuç: Tünelli hemodiyaliz kateterlerinin internal juguler ven aracılığı ile ultrasonogram ve floroskopi kılavuzluğunda yerleştirilmesi etkin ve güvenilir bir yöntemdir. USG ve floroskopi teknik başarıyı artırmakta, disfonksiyon ve komplikasyonlarm en aza indirgenmesini sağlamaktadır.

Tunneled hemodialysis placed via the internal jugular vein under the guidance of ultrasonography and fluoroscopy: A review of 152 cases

Tunneled Hemodialysis Catheters Placed Via The Internal Jugular Vein Under The Guidance of Ultrasonography And Fluoroscopy: A Review of 152 Cases Purpose: To evaluate the technical success and immediate outcomes of tunneled hemodialysis catheters placed via the internal jugular vein under the guidance of ultrasonography and fluoroscopy. Methods: Between January 2003 and April 2005, 152 tunneled hemodialysis catheters were placed via the right or left internal jugular vein under the guidance of ultrasonography and fluoroscopy in the interventional radiology unit. All cases were retrospectively analyzed for technical success, and evidence of complications, malposition or dysfunction of the catheter. Results: All catheters were placed successfully (technical success rate was 100%). No major complications such as pneumothorax, hematoma or pseudoaneurysm due to arterial puncture were observed. All catheters were positioned successfully with the tip at the atriocaval junction. In eight patients catheter kinking was observed at the internal jugular vein insertion site and this was immediately corrected before the catheter placement was completed. Conclusion: Placement of tunneled hemodialysis catheters via the internal jugular vein under the guidance of ultrasonography and fluoroscopy is an effective and reliable procedure. Ultrasonographic and fluoroscopic guidance provides excellent technical success rates, resulting in fewer complications and catheter dysfunctions.

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