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The permanent catheter.

Ek Khoon Tan1, Seck Guan Tan

  • 1Department of Vascular Surgery, Singapore General Hospital, Singapore.

Hemodialysis International. International Symposium on Home Hemodialysis
|October 30, 2013
PubMed
Summary
This summary is machine-generated.

A long-term tunneled hemodialysis catheter became permanently lodged due to vein fibrosis, highlighting risks of delayed removal. Early removal is crucial to prevent complications like infection or permanent catheterization.

Keywords:
End-stage renal failurecathetershemodialysisvascular access devices

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Area of Science:

  • Nephrology
  • Vascular Surgery

Background:

  • Tunneled hemodialysis catheters are essential for long-term renal replacement therapy.
  • Arteriovenous fistulas and grafts are preferred long-term vascular access methods.

Observation:

  • An elderly patient presented for removal of a hemodialysis catheter inserted 5 years prior.
  • Catheter removal was unsuccessful due to extensive fibrosis of the innominate vein around the device.

Findings:

  • Surgical exploration confirmed significant venous fibrosis encasing the catheter.
  • The removal procedure was abandoned, with a portion of the catheter intentionally left in place.

Implications:

  • This case underscores the risks associated with prolonged indwelling hemodialysis catheters.
  • Delayed removal, even after cuff dissection, can lead to irreversible complications.
  • Prompt removal of catheters once a functioning fistula or graft is established is recommended to mitigate risks of infection and permanent catheterization.