title: Dealing with stuck hemodialysis catheter: state of the art and tips for the nephrologist.
abstract: The term stuck catheter refers to the condition in which a catheter is not removable from a central vein using standard techniques. Although it is a rare complication, in the last few years it has been reported ever more frequently in hemodialysis due to the widespread use of tunneled catheters. Poor knowledge of the correct procedures and limited experience and training of the specialist in facing this problem are the main reasons for catheter internalization. Stuck catheter is often diagnosed by the nephrologist, who should be competent enough to manage this clinical complication. Among the many options for removing a stuck catheter from the fibrin sleeve, an interventional radiology approach, mainly with endoluminal balloon dilatation, probably provides the best solution. Vascular surgery should be reserved to selected cases in which percutaneous techniques have failed. Nephrologists must play a central role in organizing the treatment of this complication with other specialists in order to avoid making mistakes that may preclude future positive results.
authors.affiliation: Struttura Complessa a Direzione Universitaria di Nefrologia e Dialisi e Centro di Ricerche di Immunopatologia e Documentazione su Malattie Rare, Ospedale Giovanni Bosco e Università di Torino, Turin, Italy. gforneris62@gmail.com.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Forneris
authors.affiliation: Servizio di Radiologia Interventistica, Ospedale Giovanni Bosco, Turin, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Savio
authors.affiliation: Servizio di Radiologia Interventistica, Fondazione Policlinico S. Matteo, Pavia, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Quaretti
authors.affiliation: Servizio di Radiologia Interventistica, Fondazione Policlinico S. Matteo, Pavia, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Fiorina
authors.affiliation: Struttura Complessa a Direzione Universitaria di Nefrologia e Dialisi e Centro di Ricerche di Immunopatologia e Documentazione su Malattie Rare, Ospedale Giovanni Bosco e Università di Torino, Turin, Italy.
authors.forename: Pasqualina
authors.initials: P
authors.lastname: Cecere
authors.affiliation: Struttura Complessa a Direzione Universitaria di Nefrologia e Dialisi e Centro di Ricerche di Immunopatologia e Documentazione su Malattie Rare, Ospedale Giovanni Bosco e Università di Torino, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pozzato
authors.affiliation: Struttura Complessa di Chirurgia Vascolare, Ospedale Giovanni Bosco, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Trogolo
authors.affiliation: Struttura Complessa a Direzione Universitaria di Nefrologia e Dialisi e Centro di Ricerche di Immunopatologia e Documentazione su Malattie Rare, Ospedale Giovanni Bosco e Università di Torino, Turin, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Roccatello
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling; D062905:Central Venous Catheters; D020878:Device Removal / Q000009:adverse effects / Q000379:methods*; D004867:Equipment Design; D004868:Equipment Failure; D006801:Humans; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation*; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Embedded catheter; Internalization of central venous catheter; Retained catheter; Stuck catheter