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J Korean Soc Radiol. 2018 Sep;79(3):152-160. English. Original Article. https://doi.org/10.3348/jksr.2018.79.3.152
Suh PS , Park SY , Kim J , Oh CK , Lee SH , Won JH .
Department of Radiology, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea. wonkwak@ajou.ac.kr
Department of Surgery, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea.
Abstract

Purpose

To assess the venographic findings of central venous abnormalities before exchanging dysfunctional tunneled hemodialysis catheters and the outcome of endovascular salvage techniques.

Materials and Methods

A total of 110 episodes of tunneled hemodialysis catheter dysfunction in 78 patients undergoing catheter-directed hemodialysis treatment from January 2011 to December 2015 were retrospectively evaluated. Venography was performed before catheter exchange, and the following procedures were conducted according to the venographic findings: balloon disruption of a fibrin sheath, angioplasty for central vein stenosis, or stent insertion. Technical success was defined as at least one successful session of hemodialysis with the exchanged catheter. Patients were followed until the study endpoints or the last hospital visit.

Results

Venography showed abnormalities in patients with 67 of the 110 exchanged catheters, including central vein stenosis (n = 27), fibrin sheath formation (n = 17), and thrombus formation (n = 12). Technical success was confirmed in all cases. The estimated 30-day catheter patency for all assessable catheters was 61.7%. Nine catheters were removed during the follow-up period because of suspected catheter-related infections.

Conclusion

In approximately 60% of cases of dysfunctional tunneled hemodialysis catheter, abnormal venographic findings were observed in the patients. Following appropriate endovascular techniques could be helpful in improving catheter patency with a low risk of procedure-related complications.

Copyright © 2019. Korean Association of Medical Journal Editors.