title: A simple method for opening an obstructed peritoneal catheter using an infusion accelerator.
abstract: Catheter obstruction by a fibrin clot is one of the early complications after catheter implantation in continuous ambulatory peritoneal dialysis (CAPD) patients. manual compression of the dialysis solution container is usually the initial method used in an attempt to dislodge clots formed in the catheter. However, it is usually difficult to achieve and maintain sufficient pressure to open the obstructed catheter by this method. Alternatively, forceful irrigation using a syringe with heparin or urokinase, or clot removal using a corkscrew clot remover can be tried. These conventional maneuvers may potentiate the chances for bacterial contamination. In addition, these procedures require hospital visits by the patient. To solve this problem, we developed a new infusion accelerator for CAPD. Recanalization was attempted using the infusion accelerator in six cases of complete catheter obstruction. The bag was pressurized to 450 mm Hg. In all six cases, catheter patency was completely recovered without any complications. After appropriate training of patients, this method may be performed by patients themselves. Given the ease and efficiency of this procedure utilizing the improved equipment, we think that in cases with complete catheter obstruction this method should be considered before initiating more invasive procedures.
authors.affiliation: Department of nephrology, Takatuki General Hospital, Osaka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: S
authors.initials: S
authors.lastname: Yano
authors.forename: Y
authors.initials: Y
authors.lastname: Nakanishi
authors.forename: S
authors.initials: S
authors.lastname: Suzuki
authors.forename: M
authors.initials: M
authors.lastname: Tsutsumi
mesh_terms: D000328:Adult; D000368:Aged; D002408:Catheters, Indwelling; D004868:Equipment Failure; D005260:Female; D006801:Humans; D006874:Hydrostatic Pressure; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000295:instrumentation*; D013927:Thrombosis / Q000628:therapy*