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VOLUME 52 , ISSUE 3 ( July-September, 2018 ) > List of Articles


Salvage Technique for Complicated Hemodialysis Patients with Central Venous Occlusion

Leszek Sułkowski, Maciej Matyja, Artur Pasternak

Keywords : Central venous catheter, Complications, Hemodialysis, Vascular access, Venography

Citation Information : Sułkowski L, Matyja M, Pasternak A. Salvage Technique for Complicated Hemodialysis Patients with Central Venous Occlusion. J Postgrad Med Edu Res 2018; 52 (3):152-154.

DOI: 10.5005/jp-journals-10028-1292

License: CC BY-NC 4.0

Published Online: 01-04-2019

Copyright Statement:  Copyright © 2018; The Author(s).


Background: Although safe, central venous catheters (CVCs) may cause several complications including central venous occlusions. The salvage access techniques are life-saving alternatives required for patients who have exhausted other access options. Technique: We present a technique of placing a permanent catheter in the femoral vein facing the dilated collaterals. This is done in case of iliac vein and vena cava thrombosis following placement of multiple CVCs. Conclusion: This technique might be an effective alternative to the translumbar approach when performed by an experienced operator in a well-equipped access center. It must not be attempted as a blind procedure. Salvaged access can be considered when other access options have been exhausted and only translumbar or transhepatic inferior vena cava accesses are left.

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  1. Torreggiani M, Scaramuzzi ML, Manini A, Castoldi F, Serpieri N, Maggi N, Sileno G, Migotto C, Esposito V, Montagna F, et al. Hemodialysis vascular access: everything you always wanted to know about it (but were afraid to ask). J Nephrol 2013 Sep;26(5):836-847.
  2. Kotsikoris I, Zygomalas A, Papas T, Maras D, Pavlidis P, Andrikopoulou M, Tsanis A, Alivizatos V, Bessias N. Insertion of central venous catheters for hemodialysis using angiographic techniques in patients with previous multiple catheterizations. Eur J Radiol 2012 Sep;81(9):2270-2272.
  3. Niyyar VD. Catheter dysfunction: the role of lock solutions. Semin Dial 2012 Nov-Dec;25(6):693-699.
  4. Kumar NG, Dugan MM, Illig KA, Gillespie DL. Lower extremity arteriovenous fistula with central venous stenosis iliocaval stenting to treat venous outflow obstruction. J Vasc Surg 2011 Feb;53(2):487-488.
  5. Denny DF Jr. Venous access salvage techniques. Tech Vasc Interv Radiol 2011 Dec;14(4):225-232.
  6. Beigi AA, Kargari A, Ghaheri H, Davarpanahjazi AH. Comparison between two methods of central venous catheter placement in hemodialysis patients. J Isfahan Med School 2012 Jul;30(189):1-8.
  7. Skandalos LK, Samaras AA, Karakatsanis AI, Ditsias TK, Filippidis AA, Mavromatidis KS, Koutsouflianiotis NK. Insertion of permanent hemodialysis catheters through the great saphenous vein. Int J Artif Organs 2012 Jul;35(7):520-524.
  8. Haddad NJ, Van Cleef S, Agarwal AK. Central venous catheters in dialysis: the good, the bad and the ugly. Open Urol Nephrol J 2012 Jun;5(1):12-18.
  9. Shingarev R, Allon M. Peripherally inserted central catheters and other intravascular devices: how safe are they for hemodialysis patients? Am J Kidney Dis 2012 Oct;60(4):510-513.
  10. Napalkov P, Felici DM, Chu LK, Jacobs JR, Begelman SM. Incidence of catheter-related complications in patients with central venous or hemodialysis catheters: a health care claims database analysis. BMC Cardiovasc Disord 2013 Oct;13:86.
  11. Bellows PH, Anaya-Ayala JE, Cheema ZF, Davies MG, Lumsden AB, Peden EK. Combined femoral vein transposition and iliac vein to suprarenal vena cava bypass as a last resort dialysis access. Ann Vasc Surg 2011 Feb;25(2):264.e5-264.e8.
  12. Özbek IC, Sever K, Mansuroðlu D, Kaçar S Surgical treatment of catheter related superior vena cava syndrome without cardiopulmonary bypass in a patient with renal transplantation. Turk J Thorac Cardiovasc Surg 2013;21(1):187-190.
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