Recurrent venous thrombosis associated with permanent internal jugular vein hemodialysis catheters.
Eight Permcaths were placed into seven patients without other alternative hemodialysis access sites. They lasted from 1-109 treatments. However, recurrent thrombi formed at the tip of two catheters. Although urokinase successfully dissolved the thrombi, recurrence of clot despite anticoagulation therapy led to removal of both catheters. We conclude that the Permcath should be used with caution in patients on hemodialysis who have no alternative vascular access sites because of the risk of thromboembolism. The value of anticoagulants to prevent recurrent thrombi is unclear, because thrombi recurred in both patients despite their use.
Domoto
D T
DT
Department of Internal, St. Louis University School of Medicine, Missouri 63104.
Garvin
P J
PJ
D000368:Aged; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007601:Jugular Veins; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D013927:Thrombosis / Q000209:etiology*