title: Insertion of central venous catheters for hemodialysis using angiographic techniques in patients with previous multiple catheterizations.
abstract: BACKGROUND
  Central venous catheter placement is an effective alternative vascular access for dialysis in patients with chronic renal failure. The purpose of this study was to evaluate the insertion of central venous catheters for hemodialysis using angiographic techniques in patients with previous multiple catheterizations in terms of efficacy of the procedure and early complications.
  
  
  METHODS
  Between 2008 and 2010, the vascular access team of our hospital placed 409 central venous catheters in patients with chronic renal failure. The procedure was performed using the Seldinger blind technique. In 18 (4.4%) cases it was impossible to advance the guidewire, and so the patients were transported to the angiography suite.
  
  
  RESULTS
  Using the angiographic technique, the guidewire was advanced in order to position the central venous catheter. The latter was inserted into the subclavian vein in 12 (66.6%) cases, into the internal jugular vein in 4 (22.2%) and into the femoral vein in 2 (11.1%) cases. There was only one complicated case with severe arrhythmia in 1 (5.5%) patient.
  
  
  CONCLUSIONS
  Our results suggest that insertion of central venous catheters using angiographic techniques in hemodialysis patients with previous multiple catheterizations is a safe and effective procedure with few complications and high success rates.
authors: Department of Vascular Surgery, Erythros Stauros General Hospital, Greece. gkotsikoris@gmail.com
authors: Ioannis
authors: I
authors: Kotsikoris
authors: Apollon
authors: A
authors: Zygomalas
authors: Theofanis
authors: T
authors: Papas
authors: Dimitris
authors: D
authors: Maras
authors: Polyvios
authors: P
authors: Pavlidis
authors: Maria
authors: M
authors: Andrikopoulou
authors: Antonis
authors: A
authors: Tsanis
authors: Vasileios
authors: V
authors: Alivizatos
authors: Nikolaos
authors: N
authors: Bessias
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography / Q000706:statistics & numerical data; D002405:Catheterization, Central Venous / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015641:Radiography, Interventional / Q000706:statistics & numerical data*; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012086:Reoperation / Q000706:statistics & numerical data; D018570:Risk Assessment; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control*