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Percutaneous subclavian vein catheterization for hemodialysis: a report of 57 insertions
S Al-Mohaya1, M Sadat-Ali, F Al-Muhanna
1Department of General Surgery, King Faisal University Hospital, Al-Khobar, Saudi Arabia.
Insights
Subclavian vein catheterization for hemodialysis is a safe procedure with no reported deaths in this study. It offers quick vascular access for patients with kidney failure, proving effective when performed meticulously.
Area of Science:
- Nephrology
- Vascular Surgery
- Interventional Radiology
Background:
- Hemodialysis requires reliable vascular access.
- Subclavian vein catheterization is a common method for temporary access.
- Assessing the safety and efficacy of this procedure is crucial.
Purpose of the Study:
- To analyze the outcomes of subclavian vein catheterizations for hemodialysis.
- To evaluate the complication rates and safety of the procedure.
- To determine the suitability of subclavian catheterization as a primary access method.
Main Methods:
- Retrospective analysis of 57 subclavian vein catheterizations.
- Inclusion of 51 patients undergoing hemodialysis with Cobe catheters.
- Data collection on catheter dwell time, complications, and patient demographics.
Main Results:
- No catheter-related deaths occurred in 1,726 days of catheter use.
- Complications were observed in 9 patients, including cardiac arrest, pneumothorax, hydrothorax, and infections.
- Arrhythmias resolved after catheter tip readjustment; cardiac arrest patient was revived.
Conclusions:
- Percutaneous subclavian vein catheterization is a safe and effective method for hemodialysis access.
- The procedure demonstrates minimal morbidity and mortality when performed with precision.
- It is recommended as a first-choice temporary access for patients awaiting permanent vascular access.
Abstract:
The authors report an analysis of 57 subclavian vein catheterizations for hemodialysis. A total of 51 patients (34 men, 17 women) kept the Cobe single- and double-lumen catheters for 1,726 days. The youngest patient was eighteen and the oldest seventy-two years of age. There were no catheter-related deaths. Complications were encountered in 9 patients. The only life-threatening complication was cardiac arrest, which occurred during flushing of the catheter. The patient was successfully revived. The other complications were pneumothorax and hydrothorax in 1 patient, catheter site infection in 5 patients, and arrhythmias in 2 patients, which stopped after readjustment of the catheter tips. Their experience indicates that percutaneous subclavian vein catheterization is safe and provides quick access for hemodialysis with no morbidity and mortality if done correctly, patiently, and meticulously. The authors believe that this should be the first choice in patients with reversible renal failure and in patients with chronic renal failure, who are usually elderly and medically compromised, till a permanent vascular access is ready for use.