title: [A technique for inserting inadvertently removed tunneled hemodialysis catheters through the original exit site].
abstract: Accidental loss of tunneled hemodialysis (HD) central venous catheters (CVCs) is a rare complication. In the absence of other sites available for positioning a new CVC, the lack of a vascular access exposes the patient to a high risk of mortality. The technique for inserting inadvertently removed tunneled CVCs using the original exit site has never gained popularity and has been used, although with good results, in selected cases only. The purpose of this case report is to describe our experience in similar cases, and to propose a variant of the procedure described above: in 4 cases occurring over the last 12 months, our technique permitted recovery of vascular access for up to 72 hours after the loss of the CVC, with placement of a new cuffed CVC performed in the space of a few minutes. There were no cases of bleeding nor episodes of infection. The patients resumed their regular HD program with adequate performance of the CVC during a follow-up period that ranged from 3 to 12 months.In conclusion, we believe that this simple manoeuvre can help the nephrologist solve one of the dialysis room's moments of genuine emergency.
authors.forename: Carlo
authors.initials: C
authors.lastname: Lomonte
authors.forename: Francesco
authors.initials: F
authors.lastname: Casucci
authors.forename: Pasquale
authors.initials: P
authors.lastname: Libutti
authors.forename: Piero
authors.initials: P
authors.lastname: Lisi
authors.forename: Nicola
authors.initials: N
authors.lastname: Losurdo
authors.forename: Carlo
authors.initials: C
authors.lastname: Basile
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D011475:Prosthesis Failure; D019919:Prosthesis Implantation; D006435:Renal Dialysis / Q000295:instrumentation / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome