Endovascular treatment of dysfunctional hemodialysis catheters

Hemodialysis-catheter dysfunction is a common clinical condition in nephrology. Like other central venous devices, hemodialysis-catheters show a disposition for partial or complete thrombotic obstruction and fibrin sleeve formation. Thrombolytic infusion is recommended as therapy of first choice. Al...

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Bibliographic Details
Published inThe journal of vascular access Vol. 11; no. 4; p. 263
Main Authors Kamper, Lars, Piroth, Werner, Haage, Patrick
Format Journal Article
LanguageEnglish
Published United States 01.10.2010
Subjects
Angioplasty
Catheterization, Central Venous - adverse effects
Catheterization, Central Venous - instrumentation
Catheters, Indwelling - adverse effects
Endovascular Procedures - adverse effects
Equipment Design
Equipment Failure
Humans
Phlebography - methods
Radiography, Interventional
Renal Dialysis
Thrombolytic Therapy
Tomography, X-Ray Computed
Treatment Outcome
Upper Extremity Deep Vein Thrombosis - diagnostic imaging
Upper Extremity Deep Vein Thrombosis - etiology
Upper Extremity Deep Vein Thrombosis - therapy
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Summary:Hemodialysis-catheter dysfunction is a common clinical condition in nephrology. Like other central venous devices, hemodialysis-catheters show a disposition for partial or complete thrombotic obstruction and fibrin sleeve formation. Thrombolytic infusion is recommended as therapy of first choice. Alternative interventional strategies include over-the-wire catheter exchange, mechanical fibrin sleeve stripping with a snare and angioplastic sleeve disruption. Those approaches show extremely variable results with mediocre long-term patency rates. Therefore, catheter-avoiding strategies should be considered in detail and AV-fistula creation preferred.
ISSN:1724-6032
DOI:10.5301/JVA.2010.4043