[The role of the interventional radiologist in central venous catheter dysfunction (pictorial essay)].
Failure to aspirate blood from the lumen of venous catheters, inadequate blood flow and/or high resistance pressures during hemodialysis were accepted as catheter dysfunction. Other correctable problems such as residual lumen thrombus, external fibrin catheter sheath or malpositioned catheter tip were identified by contrast injection. Catheter malpositions were corrected by snare-mediated catheter repositioning or by exchange of the catheter over a guidewire. Catheters of inadequate length were exchanged over a guidewire to the appropriate position or replaced. Treatment of fibrin sheath formation included fibrin sheath stripping, guidewire catheter exchange, and urokinase infusion. Early catheter dysfunction is frequently due to mechanical problems such as inadequate positioning, kinking, or constriction. Delayed dysfunction usually results from thrombus formation, either within the lumen, around the catheter ("fibrin sleeve"), or in the host vein. In the management of catheter malfunctions and complications, interventional radiological techniques are safe and effective alternatives to standard surgical techniques.
Altunel
Ekrem
E
Ege Universitesi Tip Fakültesi, Radyoloji Anabilim Dali, Girişimsel Radyoloji Bilim Dali, Bornova, Izmir, Turkey.
Oran
Ismail
I
Parildar
Mustafa
M
Memiş
Ahmet
A
D002405:Catheterization, Central Venous / Q000295:instrumentation*; D004868:Equipment Failure; D006801:Humans; D013902:Radiography, Thoracic; D015642:Radiology, Interventional; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*