title: New tunneled haemodialysis catheter placement preserving the vasculature.
abstract: Frequent dialysis line insertion can result in central venous occlusions rendering such access of difficult catheterization. New strategies to overcome this difficulty have been reported. This problem also occurs together with accidental loss of tunneled dialysis catheters, periodically observed in chronic hemodialysis patients. We developed a new technique to apply in these situations using the old tunnel. It is exposed close to the vein puncture site and opened to insert the guidewire, advancing the new catheter along it. A new subcutaneous tunnel is performed. We report three cases with successful catheter placement using this technique. Catheters functioned appropriately and no complications were recorded. We conclude that this maneuver can be used to resolve an extruded tunneled hemodialysis catheter while at the same time preserving other vascular access routes.
authors.affiliation: Department of Nephrology, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal. acrisbraga@gmail.com
authors.forename: Ana
authors.initials: A
authors.lastname: Rocha
authors.forename: Alexandre
authors.initials: A
authors.lastname: Queirós
authors.forename: Fernanda
authors.initials: F
authors.lastname: Silva
authors.forename: António
authors.initials: A
authors.lastname: Cabrita
mesh_terms: D000368:Aged; D002405:Catheterization, Central Venous / Q000295:instrumentation* / Q000379:methods*; D002408:Catheters, Indwelling; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D016896:Treatment Outcome