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Treatment Strategies for Refractory Catheter-Related Central Venous Occlusive Disorders: Review

Xiao Ma1, Jiehao Chen2, Tianqiao Yang3

  • 1Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Hospital, Kunming, China.

Hemodialysis International. International Symposium on Home Hemodialysis
|March 15, 2025
PubMed

Insights

Catheter-related central vein occlusive disease (CVOD) management in hemodialysis patients is challenging due to limited large-scale trials. Current treatments vary, and high-quality studies are needed to determine the most effective and safe procedures for CVOD.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Catheter-related central vein occlusive disease (CVOD) is a common complication in hemodialysis patients.
  • CVOD significantly impacts patient prognosis and treatment options are diverse but lack extensive clinical validation.
  • Current management is challenging due to a lack of large-scale clinical trials for existing techniques.

Purpose of the Study:

  • To review current treatment strategies for catheter-related CVOD in hemodialysis patients.
  • To summarize the effectiveness and safety of various CVOD treatment modalities.
  • To highlight the need for further research in CVOD management.

Main Methods:

  • A comprehensive literature review was performed using PubMed.
  • Keywords included "hemodialysis", "central vein occlusion", "central vein stenosis", and "catheter".
  • Studies evaluating treatment effectiveness and safety for CVOD were analyzed.

Main Results:

  • Treatment methods for refractory CVOD include sharp recanalization, radiofrequency ablation, and percutaneous superior vena cava (SVC) puncture.
  • Complications and success rates differ significantly among treatments, with limited evidence from small studies.
  • A standardized treatment protocol for CVOD is currently lacking.

Conclusions:

  • Several promising techniques exist for treating catheter-related CVOD, but high-quality clinical studies are essential.
  • Treatment selection should consider patient specifics, occlusion extent, and resource availability.
  • Percutaneous SVC puncture is a potential alternative for refractory CVOD after failed sharp recanalization.
Abstract

Keywords:
catheter‐related CVODhemodialysisrefractorytreatment strategies

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