A clinical study of second central venous catheterization in tunnel dialysis catheter dysfunction with fibrin sheath_West China Medical Journal

Authors：

ZHANG Chunle ^1,2 , JIN Lanfei ³ , YU Yang ^1,4 ,  CUI Tianlei ^1,4 , FU Ping ^1,4

1. Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Gastroenterology, Suining Central Hospital, Suining, Sichuan 629000, P. R. China;
3. West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
4. Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

CUI Tianlei, Email: tianleicui@163.com

Keywords：

Hemodialysis vascular access; Tunnel cuffed dialysis catheter; Catheter dysfunction; Fibrin sheath; Intervention radiology

DOI：

10.7507/1002-0179.201806113

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ObjectiveTo evaluate the safety and efficacy of second central venous catheterization in tunnel cuffed dialysis catheter (TCC) dysfunction with fibrin sheath.MethodA total of 14 maintenance hemodialysis patients who required second central venous catheterization were enrolled in West China Hospital of Sichuan University from June 2016 to June 2017 and the clinical information and procedure-related complications were recorded.ResultsAll of the 14 patients were successfully performed with second central venous catheterization, of whom 4 cases had superior vena cava cannulation, 7 cases had right brachiocephalic vein cannulation, 2 cases had internal jugular vein cannulation, and 1 case had external jugular vein cannulation. No procedure-related major complication occurred. During the follow-up, catheter malfunction occurred in 2 cases, which improved by urokinase seal and catheter change, respectively. The rest patients’ catheter function remained normal.ConclusionsWith increasing difficult to construction and maintenance of vascular access, preservation of central vein resource is of high importance. For patients with TCC dysfunction with fibrin sheath, second central venous catheterization based on percutaneous brachiocephalic vein or superior vena cava cannulation is a safe and effective method to establish the lifeline for hemodialysis patients.

Citation： ZHANG Chunle, JIN Lanfei, YU Yang, CUI Tianlei, FU Ping. A clinical study of second central venous catheterization in tunnel dialysis catheter dysfunction with fibrin sheath. West China Medical Journal, 2018, 33(7): 852-855. doi: 10.7507/1002-0179.201806113 Copy

1.	National Kidney Foundation. KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update. Am J Kidney Dis, 2015, 66(5): 884-930.
2.	Santilli J. Fibrin sheaths and central venous catheter occlusions: diagnosis and management. Tech Vas Interv Radio, 2002, 5(2): 89-94.
3.	Milbrandt K, Beaudry P, Anderson R, et al. A multiinstitutional review of central venous line complications: retained intravascular fragments. J Pediatric Surg, 2009, 44(5): 972-976.
4.	Krausz DJ, Fisher JS, Rosen G, et al. Retained fibrin sheaths: chest computed tomography findings and clinical associations. J Thorac Imaging, 2014, 29(2): 118-124.
5.	李洪. 血液透析有隧道涤纶套导管粘连的治疗进展. 中国血液净化, 2016, 15(6): 327-329.
6.	Xiang DZ, Verbeken EK, Van Lommel AT, et al. Composition and formation of the sleeve enveloping a central venous catheter. J Vasc Surg, 1998, 28(2): 260-271.
7.	Savader SJ, Ehrman KO, Porter DJ, et al. Treatment of hemodialysis catheter-associated fibrin sheaths by rt-PA infusion: critical analysis of 124 procedures. J Vasc Interv Radiol, 2001, 12(6): 711-715.
8.	Ni N, Mojibian H, Pollak J, et al. Association between disruption of fibrin sheaths using percutaneous transluminal angioplasty balloons and late onset of central venous stenosis. Cardiovasc Intervent Radiol, 2011, 34(1): 114-119.
9.	Beathard GA, Arnold P, Litchfield T. Management of fibrin sheath associated with tunneled hemodialysis catheters. J Am Soc Nephrol, 2003, 14: 241.
10.	Faintuch S, Salazar GM. Malfunction of dialysis catheters: management of fibrin sheath and related problems. Tech Vasc Interv Radiol, 2008, 11(3): 195-200.
11.	National Kidney Foundation: K/DOQI clinical practice guidelines for vascular access. Am J Kidney Dis, 2006, 48: S248-S273.
12.	中国医院协会血液净化中心管理分会血液净化通路学组. 中国血液透析用血管通路专家共识 (第 1 版). 中国血液净化, 2014, 13(8): 549-558.
13.	Rahman S, Kuban JD. Dialysis catheter placement in patients with exhausted access. Tech Vasc Interv Radiol, 2017, 20(1): 65-74.
14.	杜乐熙, 刘春乘, 焦河, 等. 疑难血液透析用长期留置带涤纶套双腔导管置管一例. 华西医学, 2017, 32(12): 2029-2030.
15.	周芹, 焦河, 刘春乘, 等. 经皮无名静脉穿刺技术建立长期血液透析通路的临床研究. 中国血液净化, 2017, 16(3): 204-207.
16.	Zhai S, Zhao Q, Feng Y, et al. Placement of tunneled cuffed vascular catheter through superior vena cava puncture. J Vasc Surg Venous Lymphat Disord, 2017, 5(4): 547-552.

1. National Kidney Foundation. KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update. Am J Kidney Dis, 2015, 66(5): 884-930.
2. Santilli J. Fibrin sheaths and central venous catheter occlusions: diagnosis and management. Tech Vas Interv Radio, 2002, 5(2): 89-94.
3. Milbrandt K, Beaudry P, Anderson R, et al. A multiinstitutional review of central venous line complications: retained intravascular fragments. J Pediatric Surg, 2009, 44(5): 972-976.
4. Krausz DJ, Fisher JS, Rosen G, et al. Retained fibrin sheaths: chest computed tomography findings and clinical associations. J Thorac Imaging, 2014, 29(2): 118-124.
5. 李洪. 血液透析有隧道涤纶套导管粘连的治疗进展. 中国血液净化, 2016, 15(6): 327-329.
6. Xiang DZ, Verbeken EK, Van Lommel AT, et al. Composition and formation of the sleeve enveloping a central venous catheter. J Vasc Surg, 1998, 28(2): 260-271.
7. Savader SJ, Ehrman KO, Porter DJ, et al. Treatment of hemodialysis catheter-associated fibrin sheaths by rt-PA infusion: critical analysis of 124 procedures. J Vasc Interv Radiol, 2001, 12(6): 711-715.
8. Ni N, Mojibian H, Pollak J, et al. Association between disruption of fibrin sheaths using percutaneous transluminal angioplasty balloons and late onset of central venous stenosis. Cardiovasc Intervent Radiol, 2011, 34(1): 114-119.
9. Beathard GA, Arnold P, Litchfield T. Management of fibrin sheath associated with tunneled hemodialysis catheters. J Am Soc Nephrol, 2003, 14: 241.
10. Faintuch S, Salazar GM. Malfunction of dialysis catheters: management of fibrin sheath and related problems. Tech Vasc Interv Radiol, 2008, 11(3): 195-200.
11. National Kidney Foundation: K/DOQI clinical practice guidelines for vascular access. Am J Kidney Dis, 2006, 48: S248-S273.
12. 中国医院协会血液净化中心管理分会血液净化通路学组. 中国血液透析用血管通路专家共识 (第 1 版). 中国血液净化, 2014, 13(8): 549-558.
13. Rahman S, Kuban JD. Dialysis catheter placement in patients with exhausted access. Tech Vasc Interv Radiol, 2017, 20(1): 65-74.
14. 杜乐熙, 刘春乘, 焦河, 等. 疑难血液透析用长期留置带涤纶套双腔导管置管一例. 华西医学, 2017, 32(12): 2029-2030.
15. 周芹, 焦河, 刘春乘, 等. 经皮无名静脉穿刺技术建立长期血液透析通路的临床研究. 中国血液净化, 2017, 16(3): 204-207.
16. Zhai S, Zhao Q, Feng Y, et al. Placement of tunneled cuffed vascular catheter through superior vena cava puncture. J Vasc Surg Venous Lymphat Disord, 2017, 5(4): 547-552.

West China Medical Journal

A clinical study of second central venous catheterization in tunnel dialysis catheter dysfunction with fibrin sheath

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