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Percutaneous endovascular salvage techniques for implanted venous access device dysfunction.

Stéphane Breault1, Frédéric Glauser, Malik Babaker

  • 1Diagnostic and Interventional Radiology Department, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland, stephane.breault@chuv.ch.

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Summary
This summary is machine-generated.

Percutaneous endovascular techniques safely restore function in occluded implanted venous access devices (IVADs). Mechanical adhesiolysis effectively treats catheter adherence, improving success rates and avoiding device replacement.

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Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Medical Device Technology

Background:

  • Implanted venous access devices (IVADs) are crucial for long-term intravenous therapy.
  • Catheter occlusion by fibrin sheath or vessel wall adherence commonly causes IVAD dysfunction.
  • Restoring function is vital to avoid device replacement and maintain patient treatment continuity.

Purpose of the Study:

  • To evaluate the feasibility, safety, and efficacy of percutaneous endovascular salvage techniques for occluded IVADs.
  • To assess the effectiveness of mechanical adhesiolysis for catheter adherence.
  • To determine if these techniques can prevent the need for IVAD replacement.

Main Methods:

  • Analysis of 88 IVAD salvage procedures performed between 2005 and 2013.
  • Use of a snare to remove fibrin sheath around the catheter tip.
  • Implementation of a novel "mechanical adhesiolysis" maneuver for catheter-vessel wall adherence.

Main Results:

  • Overall technical success rate of 93.2% across 80 patients.
  • Mechanical adhesiolysis or additional maneuvers were employed in 24% of cases.
  • No complications were reported, indicating a high safety profile.

Conclusions:

  • Percutaneous endovascular salvage techniques are safe and effective for restoring IVAD function.
  • Mechanical adhesiolysis successfully mobilizes adherent catheters, enhancing success rates without added risk.
  • These procedures offer a viable alternative to catheter replacement for patients requiring continued IVAD use.