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Insertion of central venous catheters for hemodialysis using angiographic techniques in patients with previous

Ioannis Kotsikoris1, Apollon Zygomalas, Theofanis Papas

  • 1Department of Vascular Surgery, Erythros Stauros General Hospital, Greece. gkotsikoris@gmail.com

European Journal of Radiology
|July 5, 2011
PubMed

Insights

Angiographic techniques safely and effectively guide central venous catheter placement for hemodialysis in patients with prior catheterizations. This method offers high success rates and minimal early complications, improving vascular access options.

Area of Science:

  • Nephrology
  • Interventional Radiology

Background:

  • Central venous catheter (CVC) placement is a critical vascular access method for hemodialysis in chronic renal failure patients.
  • Previous catheterizations can complicate standard CVC insertion procedures.

Purpose of the Study:

  • To evaluate the efficacy and safety of using angiographic techniques for CVC insertion in hemodialysis patients with a history of multiple catheterizations.
  • To assess early complication rates associated with this interventional radiology approach.

Main Methods:

  • A retrospective analysis of 409 CVC placements between 2008 and 2010 using the Seldinger technique.
  • Patients requiring angiography due to guidewire advancement failure (18 cases, 4.4%) were analyzed for procedural success and complications.

Main Results:

  • Angiographic guidance successfully facilitated guidewire advancement for CVC placement in all 18 cases.
  • Catheter insertion sites included subclavian (66.6%), internal jugular (22.2%), and femoral (11.1%) veins.
  • A single complication (5.5%) of severe arrhythmia was observed.

Conclusions:

  • Central venous catheter insertion via angiographic techniques is a safe and effective procedure for hemodialysis patients with complex vascular access needs.
  • This method demonstrates high success rates and a low incidence of early complications, making it a valuable option for patients with multiple prior catheterizations.
Abstract

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