An unusual complication of prolonged tunneled cuffed hemodialysis catheter

A 57-year-old male patient visited our center owing to abnormal tunneled cuffed hemodialysis catheter (TC-HDC). He had been undergoing hemodialysis for 44 months. Hemodialysis was performed using a TC-HDC, which became dilatated between the hub and exit site 19 months after the initiation of hemodialysis. The first TC-HDC was exchanged using over the guidewire method. The second TC-HDC was maintained for 25 months after catheter exchange. However, the second TC-HDC was repeatedly dilatated 25 months later from the first catheter exchange. We re-exchanged the dilatated TC-HDC to the new TC-HDC using over the guidewire method. Our case presented general dilatation of both lumens without leakage. The portion of catheter dilatation was limited between the hub and exit site. The embedded segment of the catheter was preserved owing to encasement of the adjacent tissue. Our case showed that clinicians should inspect both exposed and embedded segments to prevent further catheter injury and exchange the catheter before the development of complications.