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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 6/2016

01-06-2016 | Technical Note

Sharp Central Venous Recanalization in Hemodialysis Patients: A Single-Institution Experience

Authors: Mohammad Arabi, Ishtiaq Ahmed, Abdulaziz Mat’hami, Dildar Ahmed, Naveed Aslam

Published in: CardioVascular and Interventional Radiology | Issue 6/2016

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Abstract

Purpose

We report our institutional experience with sharp central venous recanalization in chronic hemodialysis patients who failed standard techniques.

Materials and Methods

Since January 2014, a series of seven consecutive patients (four males and three females), mean age 35 years (18–65 years), underwent sharp central venous recanalization. Indications included obtaining hemodialysis access (n = 6) and restoration of superior vena cava (SVC) patency to alleviate occlusion symptoms and restore fistula function (n = 1). The transseptal needle was used for sharp recanalization in six patients, while it could not be introduced in one patient due to total occlusion of the inferior vena cava. Instead, transmediastinal SVC access using Chiba needle was obtained.

Results

Technical success was achieved in all cases. SVC recanalization achieved symptoms’ relief and restored fistula function in the symptomatic patient. One patient underwent arteriovenous fistula creation on the recanalized side 3 months after the procedure. The remaining catheters were functional at median follow-up time of 9 months (1–14 months). Two major complications occurred including a right hemothorax and a small hemopericardium, which were managed by covered stent placement across the perforated SVC.

Conclusion

Sharp central venous recanalization using the transseptal needle is feasible technique in patients who failed standard recanalization procedures. The potential high risk of complications necessitates thorough awareness of anatomy and proper technical preparedness.
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Metadata
Title
Sharp Central Venous Recanalization in Hemodialysis Patients: A Single-Institution Experience
Authors
Mohammad Arabi
Ishtiaq Ahmed
Abdulaziz Mat’hami
Dildar Ahmed
Naveed Aslam
Publication date
01-06-2016
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 6/2016
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-015-1270-5

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