Successful Removal and Replacement of a Stuck Hemodialysis Catheter via Thoracotomy: Report of Two Cases and Literature Review
Introduction: Stuck tunneled central venous catheters (CVCs) have been increasingly reported. In rare cases, the impossibility of extracting the CVC from the central vein after regular traction is the result of rigid adhesions to the surrounding fibrin sheath. Forced traction during catheter removal...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2024-04-01
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| Series: | Case Reports in Nephrology and Dialysis |
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| Online Access: | https://beta.karger.com/Article/FullText/537740 |
| _version_ | 1797201860362240000 |
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| author | Yanqin Fan Dejiao He Jing Cheng Zhenzhong Wu Yiqun Hao Hongyan Liu |
| author_facet | Yanqin Fan Dejiao He Jing Cheng Zhenzhong Wu Yiqun Hao Hongyan Liu |
| author_sort | Yanqin Fan |
| collection | DOAJ |
| description | Introduction: Stuck tunneled central venous catheters (CVCs) have been increasingly reported. In rare cases, the impossibility of extracting the CVC from the central vein after regular traction is the result of rigid adhesions to the surrounding fibrin sheath. Forced traction during catheter removal can cause serious complications, including cardiac tamponade, hemothorax, and hemorrhagic shock. Knowledge and experience on how to properly manage the stuck catheter are still limited. Case Presentation: Here, we present two cases that highlight the successful removal of the stuck tunneled CVC via thoracotomy through the close collaboration of multidisciplinary specialists in the best possible way. Both patients underwent an unsuccessful attempt at thrombolytic therapy with urokinase, catheter traction under the guidance of digital subtraction angiography and intraluminal balloon dilation. And we reviewed the literature on stuck catheters in the hope of providing knowledge and effective approaches to attempted removal of stuck catheters. Conclusion: There is no standardized procedure for dealing with stuck catheters. Intraluminal percutaneous transluminal angioplasty should be considered as the first-line treatment, while open surgery represents a second option only in the event of failure. Care must be taken that forced extubation can cause patients life-threatening. |
| first_indexed | 2024-04-24T07:54:15Z |
| format | Article |
| id | doaj.art-3f8dcf14bee04887840899ae9fde3db2 |
| institution | Directory Open Access Journal |
| issn | 2296-9705 |
| language | English |
| last_indexed | 2024-04-24T07:54:15Z |
| publishDate | 2024-04-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Nephrology and Dialysis |
| spelling | doaj.art-3f8dcf14bee04887840899ae9fde3db22024-04-18T07:17:48ZengKarger PublishersCase Reports in Nephrology and Dialysis2296-97052024-04-01141566310.1159/000537740537740Successful Removal and Replacement of a Stuck Hemodialysis Catheter via Thoracotomy: Report of Two Cases and Literature ReviewYanqin Fan0Dejiao He1Jing Cheng2Zhenzhong Wu3Yiqun Hao4Hongyan Liu5Division of Nephrology, Renmin Hospital of Wuhan University, Wuhan, ChinaDivision of Nephrology, Renmin Hospital of Wuhan University, Wuhan, ChinaDivision of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, ChinaDivision of Interventional Radiography, Renmin Hospital of Wuhan University, Wuhan, ChinaDivision of Nephrology, Renmin Hospital of Wuhan University, Wuhan, ChinaDivision of Nephrology, Renmin Hospital of Wuhan University, Wuhan, ChinaIntroduction: Stuck tunneled central venous catheters (CVCs) have been increasingly reported. In rare cases, the impossibility of extracting the CVC from the central vein after regular traction is the result of rigid adhesions to the surrounding fibrin sheath. Forced traction during catheter removal can cause serious complications, including cardiac tamponade, hemothorax, and hemorrhagic shock. Knowledge and experience on how to properly manage the stuck catheter are still limited. Case Presentation: Here, we present two cases that highlight the successful removal of the stuck tunneled CVC via thoracotomy through the close collaboration of multidisciplinary specialists in the best possible way. Both patients underwent an unsuccessful attempt at thrombolytic therapy with urokinase, catheter traction under the guidance of digital subtraction angiography and intraluminal balloon dilation. And we reviewed the literature on stuck catheters in the hope of providing knowledge and effective approaches to attempted removal of stuck catheters. Conclusion: There is no standardized procedure for dealing with stuck catheters. Intraluminal percutaneous transluminal angioplasty should be considered as the first-line treatment, while open surgery represents a second option only in the event of failure. Care must be taken that forced extubation can cause patients life-threatening.https://beta.karger.com/Article/FullText/537740stuck cathetercentral venous catheterhemodialysis accessfibrin sheathopen surgery |
| spellingShingle | Yanqin Fan Dejiao He Jing Cheng Zhenzhong Wu Yiqun Hao Hongyan Liu Successful Removal and Replacement of a Stuck Hemodialysis Catheter via Thoracotomy: Report of Two Cases and Literature Review Case Reports in Nephrology and Dialysis stuck catheter central venous catheter hemodialysis access fibrin sheath open surgery |
| title | Successful Removal and Replacement of a Stuck Hemodialysis Catheter via Thoracotomy: Report of Two Cases and Literature Review |
| title_full | Successful Removal and Replacement of a Stuck Hemodialysis Catheter via Thoracotomy: Report of Two Cases and Literature Review |
| title_fullStr | Successful Removal and Replacement of a Stuck Hemodialysis Catheter via Thoracotomy: Report of Two Cases and Literature Review |
| title_full_unstemmed | Successful Removal and Replacement of a Stuck Hemodialysis Catheter via Thoracotomy: Report of Two Cases and Literature Review |
| title_short | Successful Removal and Replacement of a Stuck Hemodialysis Catheter via Thoracotomy: Report of Two Cases and Literature Review |
| title_sort | successful removal and replacement of a stuck hemodialysis catheter via thoracotomy report of two cases and literature review |
| topic | stuck catheter central venous catheter hemodialysis access fibrin sheath open surgery |
| url | https://beta.karger.com/Article/FullText/537740 |
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