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Transhepatic catheter access for hemodialysis
Tony P Smith1, J Mark Ryan, Donal N Reddan
1Department of Radiology, Division of Interventional Radiology, Duke University Medical Center, Room 1502, Durham, NC 27710, USA. smith146@mc.duke.edu
Radiology
|May 25, 2004
Summary
Transhepatic hemodialysis catheters provide a viable solution for patients with limited vascular access options. However, these devices present maintenance challenges and potential complications, including device failure and hemorrhage.
Area of Science:
- Nephrology
- Vascular Access Procedures
- Interventional Radiology
Background:
- Patients with end-stage renal disease often require hemodialysis.
- Limited peripheral venous sites necessitate alternative vascular access strategies.
- Transhepatic catheter placement is considered when other options are exhausted.
Purpose of the Study:
- To evaluate the safety and functionality of transhepatic hemodialysis catheters.
- To assess complications and long-term patency of this access method.
Main Methods:
- Retrospective review of 21 transhepatic catheter placements in 16 patients.
- Assessment of technical success, complications, and total access site service interval.
- Kaplan-Meier survival analysis for catheter patency.
Main Results:
- All procedures achieved technical success.
- Mean service interval was 138 catheter days; no significant difference by sex.
- Complications occurred in 29% of cases, including one death; device failure was the most common reason for exchange.
Conclusions:
- Transhepatic hemodialysis catheters are a viable option for patients with limited access.
- Maintenance issues and complications require careful consideration.
- Further research may optimize outcomes for this patient population.