title: Transluminal replacement of displaced peritoneal catheter using a special "alpha-replacer" guidewire: effectiveness and limitations.
abstract: BACKGROUND
  Transluminal replacement of a displaced peritoneal catheter (TRC) using a metal guidewire is a noninvasive treatment of catheter displacement with acute malfunction. The "alpha-replacer" is a special guidewire developed specifically for TRC. This wire is usually flexible but becomes harder if coiled in the hand. Application of this unique guidewire might improve the effectiveness of TRC.
  
  
  METHODS
  TRC using an alpha-replacer was performed in 10 cases for urgent correction of peritoneal catheter displacement. All patients had received a double cuffed, straight-end swan-neck catheter.
  
  
  RESULTS
  The primary success rate of TRC using the alpha-replacer was 90% (9 of 10 cases). No patients developed complications such as injury of the peritoneum or abdominal organs. Relapse of catheter displacement was observed in 2 cases (20%) within 1 week, requiring surgical intervention to prevent relapse.
  
  
  CONCLUSIONS
  TRC using the alpha-replacer as described herein offers effective and safe treatment of peritoneal catheter displacement.
authors.affiliation: Research Division of Dialysis and Chronic Kidney Disease, Tohoku University Graduate School of Medicine, Sendai, Japan. hterawaki@mail.tains.tohoku.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Terawaki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Nakayama
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nakano
authors.forename: Toshio
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Ogura
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Hosoya
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Karino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010529:Peritoneal Cavity; D010530:Peritoneal Dialysis / Q000295:instrumentation*; D011860:Radiography, Abdominal; D015641:Radiography, Interventional; D012008:Recurrence