Placement of hemodialysis catheters with the help of the micropuncture technique in patients with central venous occlusion and limited access

Placement of hemodialysis catheters with the help of the micropuncture technique in patients with central venous occlusion and limited access

Background/aim: This study aims to describe the technical success of the micropuncture technique, which is performed in placement of tunneled hemodialysis catheters in patients with central venous occlusion and limited access. Materials and methods: A total of 25 patients with central venous occlusion and in need of catheter placement for hemodialysis between 2012 and 2018 were included in this study and analyzed retrospectively. Technical success was defined as the placement of tunneled dialysis catheters with optimal position and function. Results: Internal jugular vein access in 16 patients (14 right and 2 left) and right subclavian vein access in 3 patients were successfully performed in placement of the tunneled dialysis catheter. Although internal jugular and subclavian vein access was attempted bilaterally, the procedure failed in 6 patients. The overall technical success of recanalization of the occluded central veins was 76% (19/25). No minor or major complications were encountered. Conclusion: Tunneled dialysis catheter placement through the occluded internal jugular and subclavian veins with the micropuncture technique is effective and safe in patients with limited vascular access. The recanalization of the occluded conventional access routes should always be kept in mind to allow for the preservation of vascular accesses for future requirements.Key words: Central venous catheterization, hemodialysis, jugular veins, occlusion

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  • 1. Mandolfo S, Acconcia P, Bucci R, Corradi B, Farina M et al. Hemodialysis tunneled central venous catheters: five-year outcome analysis. The Journal of Vascular Access 2014; 15 (6): 461-465. doi:10.5301/jva.5000236
  • 2. Pereira K, Osiason A, Salsamendi J. Vascular access for placement of tunneled dialysis catheters for hemodialysis: a systematic approach and clinical practice algorithm. Journal of Clinical Imaging Science 2015; 5: 31. doi:10.4103/2156- 7514.157858
  • 3. Funaki B, Zaleski GX, Leef JA, Lorenz JN, Van Ha T et al. Radiologic placement of tunneled hemodialysis catheters in occluded neck, chest, or small thyrocervical collateral veins in central venous occlusion. Radiology 2001; 218 (2): 471-476. doi:10.1148/radiology.218.2.r01fe29471
  • 4. Denny DF Jr. Venous access salvage techniques. Techniques in Vascular and Interventional Radiology 2011; 14 (4): 225-232. doi:10.1053/j.tvir.2011.05.006
  • 5. Weeks SM. Unconventional venous access. Techniques in Vascular and Interventional Radiology 2002; 5 (2): 114-120. doi:10.1053/tvir.2002.36049
  • 6. Stavropoulos SW, Pan JJ, Clark TW, Soulen MC, ShlanskyGoldberg RD et al. Percutaneous transhepatic venous access for hemodialysis. Journal of Vascular and Interventional Radiology 2003; 14 (9): 1187-1190. doi:10.1097/01.rvi.0000085770.63355.f2
  • 7. Şanal B, Nas ÖF, Doğan N, Korkmaz M, Hacıkurt K et al. Safety and functionality of transhepatic hemodialysis catheters in chronic hemodialysis patients. Diagnostic and Interventional Radiology 2016; 22 (6): 560-565. doi: 10.5152/dir.2016.16043. PMID: 27601303; PMCID: PMC5098952
  • 8. Smith TP, Ryan JM, Reddan DN. Transhepatic catheter access for hemodialysis. Radiology 2004; 232 (1): 246-251. doi:10.1148/radiol.2321030677
  • 9. Farrell T, Lang EV, Barnhart W. Sharp recanalization of central venous occlusions. Journal of Vascular and Interventional Radiology 1999; 10 (2 Pt 1): 149-154. doi:10.1016/s1051- 0443(99)70457-4
  • 10. Zwiebel W. Venous thrombosis. In: Zwiebel W, Pellerito JS (editors). Introduction to Vascular Ultrasonography. 6th ed. Philadelphia, PA: Saunders; 2004, pp.
  • 11. Filippiadis DK, Binkert C, Pellerin O, Hoffmann RT, Krajina A et al. Cirse quality assurance document and standards for classification of complications: the Cirse classification system. Cardiovascular and Interventional Radiology 2017; 40 (8): 1141-1146. doi:10.1007/s00270-017-1703-4
  • 12. Durmaz H, Birgi E. A promising method for the salvage of thrombosed native hemodialysis fistulas: percutaneous ultrasound-guided thrombolytic injection. Turkish Journal of Medical Sciences 2019; 49 (4): 1179‐1184. doi:10.3906/sag1902-206
  • 13. Baskin JL, Pui CH, Reiss U, Wilimas JA, Metzger ML et al. Management of occlusion and thrombosis associated with long-term indwelling central venous catheters. Lancet 2009; 374 (9684): 159‐169. doi:10.1016/S0140-6736(09)60220-8
  • 14. Yadav MK, Sharma M, Lal A, Gupta V, Sharma A et al. Endovascular treatment of central venous obstruction as a complication of prolonged hemodialysis - preliminary experience in a tertiary care center. Indian Journal of Radiology and Imaging 2015; 25 (4): 368-374. doi:10.4103/0971- 3026.169463
  • 15. Caylan R, Yilmaz G, Sozen EE, Aydin K, Koksal I. Incidence and risk factors for bloodstream infections stemming from temporary hemodialysis catheters. Turkish Journal of Medical Sciences 2010; 40 (6): 835-841. doi: 10.3906/sag-0908-236
  • 16. Ferral H, Bjarnason H, Wholey M, Lopera J, Maynar M et al. Recanalization of occluded veins to provide access for central catheter placement. Journal of Vascular and Interventional Radiology 1996; 7 (5): 681-685. doi:10.1016/s1051- 0443(96)70828-x
  • 17. Too CW, Sayani R, Lim EY, Leong S, Gogna A et al. Recanalization and balloon-oriented puncture for reinsertion of dialysis catheter in nonpatent central veins (REBORN). Cardiovascular and Interventional Radiology 2016; 39 (8): 1193-1198. doi:10.1007/s00270-016-1383-5
  • 18. Murarka S, Movahed MR. The use of micropuncture technique for vascular or body cavity access. Reviews in Cardiovascular Medicine 2014; 15 (3): 245-251. doi: 10.3909/ricm0709
  • 19. Castillo D, McEwen DS, Young L, Kirkpatrick J. Micropuncture needles combined with ultrasound guidance for unusual central venous cannulation: desperate times call for desperate measurea new trick for old anesthesiologists. Anesthesia and Analgesia 2012; 114 (3): 634‐637. doi:10.1213/ANE.0b013e3182411c4e
  • 20. Gutzeit A, Schoch E, Reischauer C, Hergan K, Jenelten R et al. Comparison of a 21G micropuncture needle and a regular 19G access needle for antegrade arterial access into the superficial femoral artery. Cardiovascular and Interventional Radiology 2014; 37 (2): 343‐347. doi:10.1007/s00270-013-0669-0
  • 21. Ambrose JA, Lardizabal J, Mouanoutoua M, Buhari CF, Berg R et al. Femoral micropuncture or routine introducer study (FEMORIS). Cardiology 2014; 129 (1): 39‐43. doi:10.1159/000362536
  • 22. Funaki B. Unconventional central access: catheter insertion in collateral or in recanalized veins. Seminars in Interventional Radiology 2004; 21 (2): 111‐117. doi:10.1055/s-2004-833684
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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