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[Alternate hemodialysis catheterization access in patients with occluded peripheral venous access sites]

F K Wacker1, J Lipuma, A Blum

  • 1Klinik und Hochschulambulanz für Radiologie und Nuklearmedizin, Charité, Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin. frank.wacker@charite.de

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|July 16, 2005
PubMed

Insights

Translumbar and transhepatic hemodialysis catheter placement offers a safe alternative for patients with blocked veins. This minimally invasive procedure provides effective vascular access for end-stage renal disease patients when traditional methods fail.

Area of Science:

  • Interventional Nephrology
  • Vascular Access Procedures
  • Renal Replacement Therapy

Background:

  • Patients with end-stage renal disease often face challenges with traditional hemodialysis vascular access due to venous thrombosis.
  • Occlusion of upper and lower extremity veins, including jugular veins, necessitates alternative access strategies.

Purpose of the Study:

  • To evaluate the safety and efficacy of translumbar and transhepatic hemodialysis catheter placement.
  • To assess these methods as alternatives for patients with exhausted conventional venous access.

Main Methods:

  • Four patients with end-stage renal disease and venous thrombosis underwent percutaneous translumbar (3) and transhepatic (1) hemodialysis catheter placement.
  • Procedures were guided by fluoroscopy, with guidewire passage into the right atrium and placement of 14 F double-lumen catheters.

Main Results:

  • Successful catheter placement was achieved in all patients, with no immediate complications.
  • Hemodialysis initiation ranged from 1 to 20 hours post-placement.
  • Three patients experienced uncomplicated hemodialysis for 3-7 months; one patient had a translumbar catheter occlusion managed with rTPA and exchange.

Conclusions:

  • Transhepatic and translumbar hemodialysis catheter placement are safe and viable alternatives.
  • These techniques provide crucial vascular access for patients with limited conventional options.
Abstract

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