Endovascular treatment of dysfunctional hemodialysis catheters.
Hemodialysis-catheter dysfunction is a common clinical condition in nephrology. Like other central venous devices, hemodialysis-catheters show a disposition for partial or complete thrombotic obstruction and fibrin sleeve formation. Thrombolytic infusion is recommended as therapy of first choice. Alternative interventional strategies include over-the-wire catheter exchange, mechanical fibrin sleeve stripping with a snare and angioplastic sleeve disruption. Those approaches show extremely variable results with mediocre long-term patency rates. Therefore, catheter-avoiding strategies should be considered in detail and AV-fistula creation preferred.
Kamper
Lars
L
Department of Diagnostic and Interventional Radiology, HELIOS Klinikum Wuppertal, University Hospital Witten/Herdecke, Wuppertal, Germany. lars.kamper@helios-kliniken.de
Piroth
Werner
W
Haage
Patrick
P
D017130:Angioplasty; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D057510:Endovascular Procedures / Q000009:adverse effects; D004867:Equipment Design; D004868:Equipment Failure; D006801:Humans; D010690:Phlebography / Q000379:methods; D015641:Radiography, Interventional; D006435:Renal Dialysis; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D056824:Upper Extremity Deep Vein Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*