Life-saving vascular access in vascular capital exhaustion: single center experience in intra-atrial catheters for hemodialysis
Abstract Introduction: Intra-atrial catheter (IAC) placement through an open surgical approach has emerged as a life-saving technique in hemodialysis (HD) patients with vascular access exhaustion. Objective: To assess the complications of IAC placement, as well as patient and vascular access survi...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Nefrologia
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| Series: | Brazilian Journal of Nephrology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002017000100036&lng=en&tlng=en |
| _version_ | 1819053738965336064 |
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| author | Marta Pereira Noélia Lopez Iolanda Godinho Sofia Jorge Estela Nogueira Fernando Neves Alice Fortes António G. Costa |
| author_facet | Marta Pereira Noélia Lopez Iolanda Godinho Sofia Jorge Estela Nogueira Fernando Neves Alice Fortes António G. Costa |
| author_sort | Marta Pereira |
| collection | DOAJ |
| description | Abstract Introduction: Intra-atrial catheter (IAC) placement through an open surgical approach has emerged as a life-saving technique in hemodialysis (HD) patients with vascular access exhaustion. Objective: To assess the complications of IAC placement, as well as patient and vascular access survival after this procedure. Methods: The authors retrospectively analyzed all seven patients with vascular capital exhaustion, without immediate alternative renal replacement therapy (RRT), who underwent IAC placement between January 2004 and December 2015 at a single center. Results: Seven patients were submitted to twelve IAC placements. Bleeding (6/7) and infections (3/7) were the main complications in the early postoperative period. Two (2/7, 29%) patients died from early complications and 5/7 were discharged with a properly functioning IAC. The most frequent late complication was catheter accidental dislodgement in all remaining five patients, followed by catheter thrombosis and catheter-related infections in the same proportion (2/5). During follow-up, two of five patients died from vascular accesses complications. After IAC failure, one patient was transferred to peritoneal dialysis and a kidney transplant was performed in the other. Only one patient remains on HD after the third IAC, with a survival of 50 months. The mean patient survival after IAC placement was 19 ± 25 (0-60) months and the mean IAC patency was 8 ± 11 (0-34) months. Conclusion: Placing an IAC to perform HD is associated to significant risks and high mortality. However, when alternative RRT are exhausted, or as a bridge to others modalities, this option should be considered. |
| first_indexed | 2024-12-21T12:40:30Z |
| format | Article |
| id | doaj.art-39e0028f442e4b6298a38a9da3fa71e7 |
| institution | Directory Open Access Journal |
| issn | 2175-8239 |
| language | English |
| last_indexed | 2024-12-21T12:40:30Z |
| publisher | Sociedade Brasileira de Nefrologia |
| record_format | Article |
| series | Brazilian Journal of Nephrology |
| spelling | doaj.art-39e0028f442e4b6298a38a9da3fa71e72022-12-21T19:03:47ZengSociedade Brasileira de NefrologiaBrazilian Journal of Nephrology2175-8239391364110.5935/0101-2800.20170006S0101-28002017000100036Life-saving vascular access in vascular capital exhaustion: single center experience in intra-atrial catheters for hemodialysisMarta PereiraNoélia LopezIolanda GodinhoSofia JorgeEstela NogueiraFernando NevesAlice FortesAntónio G. CostaAbstract Introduction: Intra-atrial catheter (IAC) placement through an open surgical approach has emerged as a life-saving technique in hemodialysis (HD) patients with vascular access exhaustion. Objective: To assess the complications of IAC placement, as well as patient and vascular access survival after this procedure. Methods: The authors retrospectively analyzed all seven patients with vascular capital exhaustion, without immediate alternative renal replacement therapy (RRT), who underwent IAC placement between January 2004 and December 2015 at a single center. Results: Seven patients were submitted to twelve IAC placements. Bleeding (6/7) and infections (3/7) were the main complications in the early postoperative period. Two (2/7, 29%) patients died from early complications and 5/7 were discharged with a properly functioning IAC. The most frequent late complication was catheter accidental dislodgement in all remaining five patients, followed by catheter thrombosis and catheter-related infections in the same proportion (2/5). During follow-up, two of five patients died from vascular accesses complications. After IAC failure, one patient was transferred to peritoneal dialysis and a kidney transplant was performed in the other. Only one patient remains on HD after the third IAC, with a survival of 50 months. The mean patient survival after IAC placement was 19 ± 25 (0-60) months and the mean IAC patency was 8 ± 11 (0-34) months. Conclusion: Placing an IAC to perform HD is associated to significant risks and high mortality. However, when alternative RRT are exhausted, or as a bridge to others modalities, this option should be considered.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002017000100036&lng=en&tlng=encentral venous catheterschronic kidney failurevascular surgical procedures |
| spellingShingle | Marta Pereira Noélia Lopez Iolanda Godinho Sofia Jorge Estela Nogueira Fernando Neves Alice Fortes António G. Costa Life-saving vascular access in vascular capital exhaustion: single center experience in intra-atrial catheters for hemodialysis Brazilian Journal of Nephrology central venous catheters chronic kidney failure vascular surgical procedures |
| title | Life-saving vascular access in vascular capital exhaustion: single center experience in intra-atrial catheters for hemodialysis |
| title_full | Life-saving vascular access in vascular capital exhaustion: single center experience in intra-atrial catheters for hemodialysis |
| title_fullStr | Life-saving vascular access in vascular capital exhaustion: single center experience in intra-atrial catheters for hemodialysis |
| title_full_unstemmed | Life-saving vascular access in vascular capital exhaustion: single center experience in intra-atrial catheters for hemodialysis |
| title_short | Life-saving vascular access in vascular capital exhaustion: single center experience in intra-atrial catheters for hemodialysis |
| title_sort | life saving vascular access in vascular capital exhaustion single center experience in intra atrial catheters for hemodialysis |
| topic | central venous catheters chronic kidney failure vascular surgical procedures |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002017000100036&lng=en&tlng=en |
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