Document Detail


A retrospective comparative study of tunneled haemodialysis catheters inserted through occluded or collateral veins versus conventional methods.
MedLine Citation:
PMID:  19768497     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Tunneled hemodialysis catheters become essential in dialysis access when there is no possibility of using a functioning arteriovenous fistula. Collateral or occluded veins visible on ultrasound are used for puncture and passage of catheters into the central venous system. Chronically occluded veins are crossed with guidewires to allow dilatation and subsequent passage of hemodialysis catheters. We performed a retrospective analysis of patient demographics, comorbidities, procedural complications, functional survival, performance, and history of previous vascular access. The study group was compared with two control groups in which dialysis catheters were inserted either by radiologists in the interventional suite or by clinicians on the wards. Nineteen patients from the study group were compared with same number of patients in both control groups. The mean age of the study group was higher compared with the control groups. There was no significant difference in mean functional survival, infection rates, dialysis pump speeds in the first 2 weeks, and procedural complications between the study group and the controls. The study group had a significantly higher number of previous vascular access interventions, longer dialysis careers, and more comorbidities. Tunneled dialysis catheter placement by way of collateral or occluded veins appears safe and effective. These techniques give the operator further options when faced with patients possessing challenging vascular access. Indeed, there may be a case for preferential use of these veins to keep patent central veins in reserve.
Authors:
Steven Powell; Tze Yuan Chan; Rammohan Bhat; Kimberly Lam; Ranjeet S Narlawar; Nicola Cullen; Peter Littler
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-09-19
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  33     ISSN:  1432-086X     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-23     Completed Date:  2010-11-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  744-50     Citation Subset:  IM    
Affiliation:
Department of Radiology, Royal Liverpool University Hospital, L7 8XP Liverpool, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Catheterization, Central Venous / instrumentation*,  methods
Catheters, Indwelling*
Collateral Circulation
Female
Humans
Kidney Failure, Chronic / therapy*
Male
Middle Aged
Radiography, Interventional / methods*
Renal Dialysis / instrumentation*
Retrospective Studies
Survival Analysis
Time Factors
Treatment Outcome
Vascular Patency
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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