Document Detail


Transjugular tunnelled dialysis catheter tip placement into the inferior vena cava upper segment after length overestimation.
MedLine Citation:
PMID:  25198805     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: The right atrium is preferred over the superior vena cava (SVC) for tunnelled dialysis catheter (TDC) tip placement as it offers the best compromise between optimal catheter performance and complications. However, clinical practice guidelines are not all unanimous on this as a universal recommendation. Right atrial tip placement may also fail due to variations in body surface area, venous anatomy or TDC designs and lengths. Moreover, the presence of recurrent long intra-cardiac fibrin sheath or cardiac rhythm management device leads serves as contraindications. Extra-cardiac tip placement in the azygous, hepatic veins and lower segment of the inferior vena cava (IVC) is an alternative but is invariably associated with poor blood flow and shortened patency.
METHODS: We report the concept of extra-cardiac tip placement into the larger calibre hepatic segment IVC via a transjugular approach in two diabetic haemodialysis patients with overestimated TDC length out of 380 insertions.
RESULTS: Blood flow was maintained above 250 ml/min for 5-6 months and no tip migration ensued.
CONCLUSIONS: The IVC upper segment is a reliable site for extra-cardiac tip placement in select cases but its safety and efficacy need to be further studied in larger clinical trials.
Authors:
Claude J Renaud; Ying Ying Seow; Hui Siong Teh
Related Documents :
18713325 - Abnormal heart rate variability and subtle atrial arrhythmia in patients with familial ...
19059655 - The detrended fluctuation analysis of acute-phase heart-rate variability in acute coron...
24878215 - Management and outcomes of st-elevation myocardial infarction in nursing home versus co...
20467095 - Effects of autonomic innervation on the heart as a function of effector tissue - biomed...
25471825 - Prognostic value of speckle tracking echocardiography in patients with st-elevation myo...
11872305 - Definition of a moving gross target volume for stereotactic radiation therapy of stente...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-2
Journal Detail:
Title:  The journal of vascular access     Volume:  0     ISSN:  1724-6032     ISO Abbreviation:  J Vasc Access     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100940729     Medline TA:  J Vasc Access     Country:  -    
Other Details:
Languages:  ENG     Pagination:  0     Citation Subset:  -    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Hemodialysis vascular access construction in the upper extremity: a review.
Next Document:  Predicting outcomes in native AV forearm radio-cephalic fistulae; the CAVeA2T2 scoring system.