| Autor: |
Yuliang, Zhao, Qiuyan, Zhao, Wei, Wei, Letian, Yang, Yang, Yu, Li, Zhou, Ping, Fu, Tianlei, Cui |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
Journal of Vascular Surgery: Venous and Lymphatic Disorders. 11:318-325 |
| ISSN: |
2213-333X |
| Popis: |
Central venous occlusion (CVO) refractory to endovascular angioplasty is a critical challenge threatening hemodialysis vascular access. The present study aimed to evaluate the efficacy and safety of tunnelled cuffed central venous catheter (tCVC) placement via percutaneous superior vena cava (SVC) puncture in patients with refractory CVO.Maintenance hemodialysis patients with refractory CVO who received percutaneous puncture of SVC and tCVC insertion in a university-affiliated hospital from January 2016 to June 2020 were included. The patients were followed-up until May 2021. Demographic information, complications, and catheter patency were analyzed.A total of 205 patients were included. There were 105 females (51.2%), and the mean age was 61±15 years old. SVC puncture and tCVC insertion were successfully performed in 194 patients, achieving a technical success rate of 94.6%. A patient unfortunately encountered pleura injury and hemothorax who required urgent thoracotomy. Thirty-seven patients presented with mild chest pain and were prescribed oral NSAIDs. During the follow-up of those 194 patients with a successful procedure, catheter dysfunction due to thrombosis occurred in 66 patients, while 5 patients suffered from catheter malposition and 6 patients encountered catheter related-blood stream infection. The 3-year primary patency rate was 64.2%, and the 3-year secondary patency rate was 76.3%.TCVC placed through percutaneous SVC puncture had a satisfactory technical success rate and long-term patency rate in hemodialysis patients, providing optional vascular access for those with exhausted central vein resources. SVC puncture also avoided left-sided catheters and preserved central vein resources. Caution should be paid to avoid potential complications such as pleura injury and hemothorax. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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