title: Balloon angioplasty for disruption of tunneled dialysis catheter fibrin sheath.
abstract: OBJECTIVE
  Management of failing tunneled hemodialysis catheters, sometimes the only vascular access for hemodialysis, presents a difficult problem. In spite of various techniques having been developed, no consensus has been reached about the preferred technique, associated with the longest catheter patency.
  
  
  METHODS
  We report disruption of the fibrin sheath covering dysfunctional tunneled hemodialysis catheter by means of angioplasty, followed by over guidewire catheter exchange.
  
  
  RESULTS
  Following the procedure, the catheter placed in the recovered lumen of the vessel presented correct function.
  
  
  CONCLUSIONS
  The described procedure allowed maintenance of vascular access in our patient. Additionally, dilatation of the concomitant central vein stenosis opens an option for another attempt for arteriovenous fistula creation.
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland. ewatorek@w.pl
authors.forename: Ewa
authors.initials: E
authors.lastname: Watorek
authors.forename: Tomasz
authors.initials: T
authors.lastname: Golebiowski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Letachowicz
authors.forename: Jerzy
authors.initials: J
authors.lastname: Garcarek
authors.forename: Jacek
authors.initials: J
authors.lastname: Kurcz
authors.forename: Hanna Augustyniak
authors.initials: HA
authors.lastname: Bartosik
authors.forename: Waldemar
authors.initials: W
authors.lastname: Letachowicz
authors.forename: Waclaw
authors.initials: W
authors.lastname: Weyde
authors.forename: Marian
authors.initials: M
authors.lastname: Klinger
mesh_terms: D000800:Angioplasty, Balloon; D016121:Brachiocephalic Veins / Q000737:chemistry* / Q000000981:diagnostic imaging; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D020878:Device Removal; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005337:Fibrin / Q000032:analysis*; D006801:Humans; D010690:Phlebography; D006435:Renal Dialysis; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D014683:Vena Cava, Superior / Q000737:chemistry* / Q000000981:diagnostic imaging
chemical_list: D005337:Fibrin