Percutaneous transhepatic hemodialysis catheters in chronic hemodialysis patients: technique, functional outcome, and complications from a large population study

Abstract Background Chronic renal failure is one of the main health problems in Egypt. Arterio-venous fistulas, grafts, as well as conventional sites for placement of the dialysis catheters are liable to thrombosis; stenosis, and occlusions, so alternative routes are considered as life-saving ways i...

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Main Authors: Osama Abuel Naga Khallaf, Karim A. Abd El Tawab, Hazem Ibrahim Korashi, Ghada Samir Ibrahim, Rasha Samir Mohamed
Format: Article
Language:English
Published: SpringerOpen 2019-12-01
Series:The Egyptian Journal of Radiology and Nuclear Medicine
Subjects:
Online Access:https://doi.org/10.1186/s43055-019-0074-z
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author Osama Abuel Naga Khallaf
Karim A. Abd El Tawab
Hazem Ibrahim Korashi
Ghada Samir Ibrahim
Rasha Samir Mohamed
author_facet Osama Abuel Naga Khallaf
Karim A. Abd El Tawab
Hazem Ibrahim Korashi
Ghada Samir Ibrahim
Rasha Samir Mohamed
author_sort Osama Abuel Naga Khallaf
collection DOAJ
description Abstract Background Chronic renal failure is one of the main health problems in Egypt. Arterio-venous fistulas, grafts, as well as conventional sites for placement of the dialysis catheters are liable to thrombosis; stenosis, and occlusions, so alternative routes are considered as life-saving ways in such cases. Transhepatic permcath is one of the new and up to date methods for inferior vena cava and right atrium catheterization. Few studies with rather limited nomber are available to evaluate transhepatic permcath. The aim of our study is to emphasize the technique, complications, and efficacy of application of percutaneous transhepatic hemodialysis catheters. Results Two hundred-ninety six chronic renal dialysis patients were included in this prospective interventional study. They include 180 males and 116 females with mean age of 53.2 years ± 11.7 years ranging from 38 to 65 years. Percutaneous transhepatic hemodialysis catheters were inserted for all patients. Technical success of the procedure was achieved in all cases (100%). Post-procedure patency and function of the catheters were followed up with mean follow-up period 750 days. Mean of primary and secondary devices service intervals were 290 and 270 days respectively. Mean time catheter in situ was 280 days. Mean cumulative duration of catheter in situ was 557 days. Catheters migration, sepsis, thrombosis, and exit site infection rates were 0.14, 0.15, 0.18, and 0.32 per 100 catheter-days respectively. Three patients had hepatic subcapsular hematoma (1%). No mortality or other complications were related to the procedure. Conclusions Combined ultrasound and fluoroscopic-guided transhepatic permanent dialysis catheter application for patients with exhausted classic venous access routes and non-functioning/thrombosed AV fistulas or grafts showed excellent technical success with good short and mid-term patency rates and low complications rates. Thus, this study encourages us to expand this promising technique for application of dialysis catheter in indicated cases.
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spelling doaj.art-ca97a5db37c44627aa79cd57f3889cdc2022-12-21T22:21:04ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622019-12-015011710.1186/s43055-019-0074-zPercutaneous transhepatic hemodialysis catheters in chronic hemodialysis patients: technique, functional outcome, and complications from a large population studyOsama Abuel Naga Khallaf0Karim A. Abd El Tawab1Hazem Ibrahim Korashi2Ghada Samir Ibrahim3Rasha Samir Mohamed4Department of Radio-diagnosis, Faculty of Medicine, Ain Shams UniversityDepartment of Radio-diagnosis, Faculty of Medicine, Ain Shams UniversityDepartment of Radio-diagnosis, Faculty of Medicine, Ain Shams UniversityDepartment of Radio-diagnosis, Faculty of Medicine, Ain Shams UniversityInternal Medicine Department, Faculty of Medicine, Ain Shams UniversityAbstract Background Chronic renal failure is one of the main health problems in Egypt. Arterio-venous fistulas, grafts, as well as conventional sites for placement of the dialysis catheters are liable to thrombosis; stenosis, and occlusions, so alternative routes are considered as life-saving ways in such cases. Transhepatic permcath is one of the new and up to date methods for inferior vena cava and right atrium catheterization. Few studies with rather limited nomber are available to evaluate transhepatic permcath. The aim of our study is to emphasize the technique, complications, and efficacy of application of percutaneous transhepatic hemodialysis catheters. Results Two hundred-ninety six chronic renal dialysis patients were included in this prospective interventional study. They include 180 males and 116 females with mean age of 53.2 years ± 11.7 years ranging from 38 to 65 years. Percutaneous transhepatic hemodialysis catheters were inserted for all patients. Technical success of the procedure was achieved in all cases (100%). Post-procedure patency and function of the catheters were followed up with mean follow-up period 750 days. Mean of primary and secondary devices service intervals were 290 and 270 days respectively. Mean time catheter in situ was 280 days. Mean cumulative duration of catheter in situ was 557 days. Catheters migration, sepsis, thrombosis, and exit site infection rates were 0.14, 0.15, 0.18, and 0.32 per 100 catheter-days respectively. Three patients had hepatic subcapsular hematoma (1%). No mortality or other complications were related to the procedure. Conclusions Combined ultrasound and fluoroscopic-guided transhepatic permanent dialysis catheter application for patients with exhausted classic venous access routes and non-functioning/thrombosed AV fistulas or grafts showed excellent technical success with good short and mid-term patency rates and low complications rates. Thus, this study encourages us to expand this promising technique for application of dialysis catheter in indicated cases.https://doi.org/10.1186/s43055-019-0074-zPer-cutaneous transhepatic hemodialysis cathetersTechniqueComplications
spellingShingle Osama Abuel Naga Khallaf
Karim A. Abd El Tawab
Hazem Ibrahim Korashi
Ghada Samir Ibrahim
Rasha Samir Mohamed
Percutaneous transhepatic hemodialysis catheters in chronic hemodialysis patients: technique, functional outcome, and complications from a large population study
The Egyptian Journal of Radiology and Nuclear Medicine
Per-cutaneous transhepatic hemodialysis catheters
Technique
Complications
title Percutaneous transhepatic hemodialysis catheters in chronic hemodialysis patients: technique, functional outcome, and complications from a large population study
title_full Percutaneous transhepatic hemodialysis catheters in chronic hemodialysis patients: technique, functional outcome, and complications from a large population study
title_fullStr Percutaneous transhepatic hemodialysis catheters in chronic hemodialysis patients: technique, functional outcome, and complications from a large population study
title_full_unstemmed Percutaneous transhepatic hemodialysis catheters in chronic hemodialysis patients: technique, functional outcome, and complications from a large population study
title_short Percutaneous transhepatic hemodialysis catheters in chronic hemodialysis patients: technique, functional outcome, and complications from a large population study
title_sort percutaneous transhepatic hemodialysis catheters in chronic hemodialysis patients technique functional outcome and complications from a large population study
topic Per-cutaneous transhepatic hemodialysis catheters
Technique
Complications
url https://doi.org/10.1186/s43055-019-0074-z
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