Percutaneous fibrin sleeve stripping of failing haemodialysis catheters

BACKGROUND: One of the most frequent reasons for failure of haemodialysis lines is catheter blockage caused by fibrin sheath formation. We report our experience of percutaneous fibrin sheath stripping in treating this problem. METHODS: A consecutive series of failing haemodialysis catheters underwen...

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Published inNephrology, dialysis, transplantation Vol. 14; no. 3; pp. 688 - 691
Main Authors Johnstone, R D, Stewart, G A, Akoh, J A, Fleet, M, Akyol, M, Moss, J G
Format Journal Article
LanguageEnglish
Published Oxford Oxford University Press 01.03.1999
Subjects
Biological and medical sciences
Catheterization - instrumentation
Diseases of the urinary system
Female
Fibrin
Humans
Male
Medical sciences
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Renal Dialysis - instrumentation
Human
Stripping
Venous access
Prognosis
Hemodialysis
Catheter
Stenosis
Instrumentation therapy
Sheath
Percutaneous route
Extrarenal dialysis
Fibrin
Complication
Technique
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Summary:BACKGROUND: One of the most frequent reasons for failure of haemodialysis lines is catheter blockage caused by fibrin sheath formation. We report our experience of percutaneous fibrin sheath stripping in treating this problem. METHODS: A consecutive series of failing haemodialysis catheters underwent percutaneous fibrin sheath stripping in an attempt to retrieve and prolong the life of the catheter. Immediate technical success, clinical success, and primary and secondary patency were measured based on clinical follow-up. RESULTS: Sixteen non-functional permanent haemodialysis lines in 15 patients underwent percutaneous fibrin sheath stripping on 21 occasions. Technical success rate was 100%. Catheter flow rates sufficient for initial dialysis were achieved in 12 (75%) lines. Successful percutaneous fibrin sheath stripping produced a mean catheter patency of 126 days (range 6-299 days). CONCLUSIONS: Percutaneous fibrin sheath stripping is a simple, repeatable procedure that can usefully extend the life of a failing dialysis line. However, a randomized trial will be needed to evaluate its role compared with catheter replacement.
Bibliography:PMID:10193820
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ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/14.3.688