[Emergency vascular access in patients with renal failure. Apropos of 32 implantations of permcath].
Central venous catheters allow for the most rapid hemodialysis procedure with sparing of peripheral blood vessels. 32 flexible, double-lumen "permcath" catheters were implanted to 27 patients over a period spanning 42 months (February 86-August 89). Catheter placement was definitive in 2 cases while another 30 provided previsory intravenous access for plasmapheresis (25 cases), acute renal insufficiency (7 cases), and chronic renal failure (17 cases). The mean utilization time per patient was 10.7 +/- 8.01 (SE) weeks. As respects chronic renal failure, this provided a time-opportunity for prospective maturation of conventional venous routes of access or transplantation. Permcath thrombosis occurred in 6 instances (18.75%), 5 times unremittingly (15.4%). Infection occurred in 6 patients (18.75%), leading to ablation of the permcath only once. Thus, permcath ensures safe, effective access for hemodialysis and enables maturation of a conventional venous cutdown. It may be used directly as a permanent vascular approach in case of limited life expectancy or of an extremely precarious vascular bed.
Chatelard
P
P
Service de chirurgie générale et vasculaire, centre hospitalier Lyon Sud, Pierre Bénite.
Trolliet
P
P
Gilly
F
F
Devolfe
C
C
Caillot
J L
JL
Chazot
C
C
François
B
B
Bouchet
A
A
D058186:Acute Kidney Injury; D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D004630:Emergencies; D005260:Female; D006801:Humans; D007239:Infections / Q000209:etiology; D007676:Kidney Failure, Chronic; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D006435:Renal Dialysis; D013927:Thrombosis / Q000209:etiology
L'abord vasculaire de secours chez l'insuffisant rénal. A propos de 32 implantations de permcath.