Fulltext

Placement of Hemodialysis Catheters Through Stenotic or Occluded Central Thoracic Veins

Haller, Claude ; Déglise, Sébastien ; Saucy, Francois ; Mathieu, Claudine ; Haesler, Erik ; Doenz, Francesco ; Corpataux, Jean ; Qanadli, Salah

In: CardioVascular and Interventional Radiology, 2009, vol. 32, no. 4, p. 695-702

Aggiungi alla tua lista
    Titre
    • Placement of Hemodialysis Catheters Through Stenotic or Occluded Central Thoracic Veins
    Auteur
    • Haller, Claude. Unit of Thoracic and Vascular Surgery, CHUV-University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Déglise, Sébastien. Unit of Thoracic and Vascular Surgery, CHUV-University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Saucy, Francois. Unit of Thoracic and Vascular Surgery, CHUV-University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Mathieu, Claudine. Unit of Nephrology, CHUV-University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Haesler, Erik. Unit of Vascular Medicine, CHUV-University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Doenz, Francesco. Unit of Interventional Radiology, CHUV-University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Corpataux, Jean. Unit of Thoracic and Vascular Surgery, CHUV-University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Qanadli, Salah. Unit of Interventional Radiology, CHUV-University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • CardioVascular and Interventional Radiology, 2009, vol. 32, no. 4, p. 695-702. Springer-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:314703
    Summary
    A method for hemodialysis catheter placement in patients with central thoracic venous stenosis or occlusion is described and initial results are analyzed. Twelve patients, with a mean age of 63.2years (42-80years), with central venous stenosis or occlusion, and who required a hemodialysis catheter were reviewed. All lesions were confirmed by helical CT or phlebography. Five patients had stenosis while seven patients were diagnosed with an occlusion of thoracic central veins. All patients were asymptomatic, without sign of superior vena cava syndrome. After percutaneous transstenotic catheterization or guidewire-based recannalization in occlusions, a balloon dilatation was performed and a stent was placed, when necessary, prior to catheter placement. Technical success was 92%. Three patients had angioplasty alone and nine patients had angioplasty with stent placement. Dialysis catheters were successfully inserted through all recannalized accesses. No immediate complication occurred, nor did any patient develop superior vena cava syndrome after the procedure. The mean follow-up was 21.8months (range, 8-48months). Three patients developed a catheter dysfunction with fibrin sheath formation (at 7, 11, and 12months after catheter placement, respectively). Two were successfully managed by percutaneous endovascular approach and one catheter was removed. In conclusion, for patients with central venous stenosis or occlusion and those who need a hemodialysis catheter, catheter insertion can be reliably achieved immediately after endovascular recannalization with acceptable technical and long-term success rates. This technique should be considered as an alternative procedure for placing a new hemodialysis catheter through a patent vein