Dialysis catheter insertion using Surfacer Inside-Out Access Catheter System in a heart transplant recipient

Area of Science:

• Nephrology
• Vascular Surgery
• Interventional Radiology

Background:

• Central venous occlusion (CVO) is a frequent complication in patients requiring hemodialysis.
• Patients with end-stage kidney disease often face challenges with vascular access due to multiple failed attempts and CVO.
• Heart transplant recipients have increased risks for vascular complications, including anastomotic stenoses and fragility from long-term steroid use.

Purpose of the Study:

• To report the first successful tunneled dialysis catheter (TDC) insertion using Surfacer Inside-Out technology in a heart transplant recipient with bilateral central venous occlusions.
• To evaluate the safety and feasibility of the Surfacer technique in patients with exhausted vascular access and CVO.

Main Methods:

• A case report of a 74-year-old heart transplant recipient with end-stage kidney disease and bilateral CVO.
• Utilized the Surfacer Inside-Out Access Catheter System for right internal jugular vein re-canalization.
• Successful insertion of a tunneled dialysis catheter (TDC).

Main Results:

• The Surfacer Inside-Out technology enabled successful re-canalization of the occluded right internal jugular vein.
• A tunneled dialysis catheter was safely and effectively inserted in a complex heart transplant recipient with CVO.
• Demonstrated feasibility of the Surfacer technique in patients with exhausted vascular access.

Conclusions:

• The Surfacer Inside-Out technique is a safe and feasible option for TDC insertion in hemodialysis patients with central venous occlusions.
• This approach provides a viable solution for patients with limited vascular access options, including heart transplant recipients.
• The study highlights the potential of advanced endovascular techniques to manage complex vascular access challenges.