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J Vasc Access ; 22(2): 203-208, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32588722

RESUMO

OBJECTIVE: To study and discuss treatments for stuck tunneled cuffed catheter in patients undergoing maintenance hemodialysis. METHOD: Retrospectively analyzing clinical data of 13 patients with stuck tunneled cuffed catheter in the Kidney Disease Center of the First Affiliated Hospital, College of Medicine, Zhejiang University in the period between September 2012 and October 2018. All patients failed to remove hemodialysis catheters by regular technique. The stuck catheters were treated by thoracotomy, endoluminal percutaneous transluminal angioplasty with blunt dissection or embedded and left in situ. RESULTS: In 13 patients, one was successfully treated by thoracotomy, one failed to remove the catheter by regular technique and blunt dissection, and the stump of the catheter was clamped and buried in the subcutaneous fascia of the neck, and the other 11 were treated by endoluminal percutaneous transluminal angioplasty with blunt dissection. The average time of catheter removal procedure is 25 min, the overall success rate is 92.3%, and the success rate of percutaneous transluminal angioplasty is 100%. CONCLUSION: Thoracotomy is an efficient way to treat stuck catheter but is limited by its high risk and complications. Leaving part of catheter in situ may increase the risk of central vein stenosis. Comparing to the former two, endoluminal percutaneous transluminal angioplasty is a safe, efficient, and practical way for stuck catheters and should be recommended as the first choice.


Assuntos
Angioplastia , Cateterismo Venoso Central/instrumentação , Cateteres de Demora , Cateteres Venosos Centrais , Remoção de Dispositivo , Dissecação , Diálise Renal , Toracotomia , Adulto , Idoso , Angioplastia/efeitos adversos , Cateterismo Venoso Central/efeitos adversos , China , Tomada de Decisão Clínica , Remoção de Dispositivo/efeitos adversos , Dissecação/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Toracotomia/efeitos adversos , Resultado do Tratamento
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