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Percutaneous transhepatic venous access for hemodialysis
S William Stavropoulos1, John J Pan, Timothy W I Clark
1Division of Interventional Radiology, Department of Radiology, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, Pennsylvania 19104, USA. stav@rad.upenn.edu
Abstract:
Percutaneous transhepatic venous access is an option for hemodialysis patients who have exhausted more traditional sites of venous access. Thirty-six transhepatic dialysis catheters were placed in 12 patients. The mean time of the catheters in situ was 24.3 days. Twenty-one catheters were replaced or removed because of catheter thrombosis, yielding a catheter thrombosis rate of 2.40 per 100 catheter-days. The line sepsis rate was 0.22 per 100 catheter-days. Poor patency rates were seen because of a high rate of late thrombosis. Transhepatic dialysis catheters should only be used as a last resort unless limitations of catheter thrombosis can be overcome.