Related Experiment Video
Updated: Jun 3, 2025
A Murine Model of Hemodialysis Access-Related Hand Dysfunction
Published on: May 31, 2022
Risk Factors for Internal Jugular Vein Thrombosis 1 Month After Non-Cuffed Hemodialysis Catheter Removal
Shun Yoshida1,2, Yasuyo Sato1,2, Tsukasa Naganuma1
1Department of Nephrology, Yamanashi Prefectural Central Hospital, Yamanashi 400-8506, Japan.
Insights
Catheter-related thrombosis (CRT) persisted in nearly 30% of patients one month after non-cuffed hemodialysis catheter removal. Arteriovenous access dysfunction and enlarged lymph nodes were key risk factors for this residual thrombus.
Area of Science:
- Nephrology
- Vascular Surgery
- Radiology
Background:
- Non-cuffed hemodialysis catheters are crucial for emergency vascular access but are linked to complications like catheter-related thrombosis (CRT) and venous stenosis.
- Limited data exists on venous lumen changes and persistent thrombosis post-catheter removal.
- This study addresses the gap by investigating risk factors for residual thrombus one month after hemodialysis catheter removal.
Purpose of the Study:
- To identify risk factors associated with persistent catheter-related thrombosis (CRT) one month after the removal of non-cuffed hemodialysis catheters.
- To evaluate the long-term impact of emergency vascular access on venous structures.
- To inform potential interventions for preventing persistent CRT.
Main Methods:
- Prospective observational study from June 2021 to October 2022.
- Inclusion of end-stage kidney disease patients with internal jugular vein (IJV) hemodialysis catheter placement.
- Vascular ultrasound assessment of IJV thrombus and vein properties post-catheter removal and at one-month follow-up.
Main Results:
- All patients showed thrombus at the catheter removal site immediately after removal.
- Eleven out of 37 followed patients (29.7%) had residual thrombus one month post-removal.
- Arteriovenous (AV) access dysfunction and enlarged lymph nodes during catheter removal were significant predictors of residual thrombus, even after adjusting for covariates.
Conclusions:
- Catheter-related thrombosis (CRT) persists in a significant proportion (29.7%) of patients one month after non-cuffed hemodialysis catheter removal.
- Early identification and intervention for patients with AV access dysfunction and enlarged lymph nodes may mitigate persistent CRT.
- This highlights the importance of post-removal venous surveillance and targeted management strategies.
Abstract:
Background: Complications, namely, catheter-related thrombosis (CRT) and venous stenosis, are associated with non-cuffed hemodialysis catheters used for emergency vascular access. However, only a few reports have demonstrated changes in the venous lumen and intravenous thrombosis after catheter removal. In this study, we comprehensively investigated the risk factors for residual thrombus 1 month after hemodialysis catheter removal. Methods: This prospective observational study was conducted from June 2021 to October 2022. We included patients with end-stage kidney disease who underwent hemodialysis catheter placement in the internal jugular vein (IJV). After catheter removal, we observed the IJV using vascular ultrasound and evaluated the thrombus and vein properties. Furthermore, we observed thrombosis 1 month after catheter removal, and investigated the risk factors for residual thrombus 1 month after catheter removal. Results: A thrombus was observed at the site of catheter removal in all the cases. Of the 37 patients who were followed up, 11 exhibited a residual thrombus 1 month after catheter removal. Patients with arteriovenous (AV) access dysfunction and enlarged lymph nodes during catheter removal were significantly more likely to have a residual thrombus 1 month after catheter removal. These associations remained significant even after adjusting for age, sex, and diabetes status. Conclusions: In 29.7% of the patients, CRT persisted even 1 month after the removal of the non-cuffed hemodialysis catheter. The provision of early intervention in patients with AV access dysfunction and enlarged lymph nodes during catheter removal may prevent CRT persistence.
