A New Procedure for Guidewire Exchange of Tunneled Hemodialysis Catheters in Chronic Hemodialysis Patients: A Pilot Study

Hemodialysis – Research Article

Leclaire C.a· Lobbedez T.a· Henri P.a· Lanot A.a· Gautier N.a· Béchade C.a,b· Ficheux M.a

Author affiliations

aNormandie Univ, UNICAEN, CHU de Caen Normandie, Néphrologie, Caen, France
bANTICIPE, U1086 INSERM-UCN, Centre François Baclesse, Caen, France

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Article / Publication Details

First-Page Preview

Abstract of Hemodialysis – Research Article

Received: November 14, 2021
Accepted: May 27, 2022
Published online: July 06, 2022

Number of Print Pages: 10
Number of Figures: 11
Number of Tables: 3

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

Abstract

Introduction: Different techniques of guidewire exchange of tunneled catheters for hemodialysis (HD) have been reported. This study was carried out to assess the feasibility of a new procedure in chronic HD patients who needed catheter exchange because of mechanical dysfunction. Methods: The guidewire exchange method was based on the creation of a new exit site and a new subcutaneous tunnel while using the same venous insertion site. This was a retrospective study of exchanged tunneled catheters because of mechanical complications in patients on chronic HD between June 1, 2015, and December 31, 2019. The feasibility of the procedure was defined by successful exchange and catheter patency at 6 months. Catheter survival and immediate complications were reported. Results: A total of 49 procedures were performed in 34 HD patients. There was no catheter insertion failure. At 6 months, 6 catheters have lost their patency because of a mechanical complication. Thus, the success rate of the procedure was 43/49 (87.8%). Catheter survival censored on death, transplantation, or vascular access creation was 97.8% at 90 days, 86.2% at 180 days, and 74.5% at 1 year. The median catheter survival was 10.2 months. Among the 49 procedures, there were 9 hematomas at the insertion site that did not require surgical intervention. Discussion/Conlusion: Our study shows that guidewire exchange of a tunneled HD catheter by creating a new exit site and a new subcutaneous tunnel by using the same venous access is a newer method in chronic HD patients. This procedure should not be used in patients with coagulation issues. Additional studies are needed to compare the different methods of HD catheter exchange.

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References Réseau epidémiologie information néphrologie-rapport annuel. 2018. https://www.agence-biomedecine.fr/Le-rapport-du-REIN-2018-est-en-ligne (accessed July 8, 2020). Lok CE, Huber TS, Lee T, Shenoy S, Yevzlin AS, Abreo K, et al. KDOQI clinical practice guideline for vascular access: 2019 update. Am J Kidney Dis. 2020;75(4 Suppl 2):S1–164. United States Renal Data System. USRDS annual data report: epidemiology of kidney disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2020. Suhocki PV, Conlon PJ, Knelson MH, Harland R, Schwab SJ. Silastic cuffed catheters for hemodialysis vascular access: thrombolytic and mechanical correction of malfunction. Am J Kidney Dis. 1996;28(3):379–86. Kennard AL, Walters GD, Jiang SH, Talaulikar GS. Interventions for treating central venous haemodialysis catheter malfunction. Cochrane Database Syst Rev. 2017;10:CD011953. Tedla FM, Clerger G, Distant D, Salifu M. Prevalence of central vein stenosis in patients referred for vein mapping. Clin J Am Soc Nephrol. 2018;13(7):1063–8. Labriola L, Seront B, Crott R, Borceux P, Hammer F, Jadoul M. Superior vena cava stenosis in haemodialysis patients with a tunnelled cuffed catheter: prevalence and risk factors. Nephrol Dial Transplant. 2018;33(12):2227–33. Carlisle EJ, Blake P, McCarthy F, Vas S, Uldall R. Septicemia in long-term jugular hemodialysis catheters; eradicating infection by changing the catheter over a guidewire. Int J Artif Organs. 1991;14(3):150–3. Garofalo RS, Zaleski GX, Lorenz JM, Funaki B, Rosenblum JD, Leef JA. Exchange of poorly functioning tunneled permanent hemodialysis catheters. AJR Am J Roentgenol. 1999;173(1):155–8. Duszak R, Haskal ZJ, Thomas-Hawkins C, Soulen MC, Baum RA, Shlansky-Goldberg RD, et al. Replacement of failing tunneled hemodialysis catheters through pre-existing subcutaneous tunnels: a comparison of catheter function and infection rates for de novo placements and over-the-wire exchanges. J Vasc Interv Radiol. 1998;9(2):321–7. McLaughlin K, Jones B, Mactier R, Porteus C. Long-term vascular access for hemodialysis using silicon dual-lumen catheters with guidewire replacement of catheters for technique salvage. Am J Kidney Dis. 1997;29(4):553–9. Wang J, Nguyen TA, Chin AI, Ross JL. Treatment of tunneled dialysis catheter malfunction: revision versus exchange. J Vasc Access. 2016;17(4):328–32. Merport M, Murphy TP, Egglin TK, Dubel GJ. Fibrin sheath stripping versus catheter exchange for the treatment of failed tunneled hemodialysis catheters: randomized clinical trial. J Vasc Interv Radiol. 2000;11(9):1115–20. Hou SM, Chou PC, Huang CH, Chin CH, Wang PC, Chen YH. Is guidewire exchange a better approach for subclavian vein re-catheterization for chronic hemodialysis patients? Thromb Res. 2006;118(4):439–45. Lai CH, Kan CD, Wu HY, Luo CY, Chao CM, Wen JS. Modified exchange technique for management of dysfunctional tunneled hemodialysis catheters in the presence of exit-site infection: a quality improvement report. Am J Kidney Dis. 2009;53(1):112–20. Onder AM, Chandar J, Saint-Vil M, Lopez-Mitnik G, Abitbol CL, Zilleruelo G. Catheter survival and comparison of catheter exchange methods in children on hemodialysis. Pediatr Nephrol. 2007;22(9):1355–61. Egglin TK, Rosenblatt M, Dickey KW, Houston JP, Pollak JS. Replacement of accidentally removed tunneled venous catheters through existing subcutaneous tracts. J Vasc Interv Radiol. 1997;8(2):197–202. Atray N, Asif A. New tunneled hemodialysis catheter placement through the old exit site. Semin Dial. 2008;21(1):97–9. Alomari AI, Falk A. The natural history of tunneled hemodialysis catheters removed or exchanged: a single-institution experience. J Vasc Interv Radiol. 2007;18(2):227–35. Tanriover B, Carlton D, Saddekni S, Hamrick K, Oser R, Westfall AO, et al. Bacteremia associated with tunneled dialysis catheters: comparison of two treatment strategies. Kidney Int. 2000;57(5):2151–5. Chaitowitz I, Heng R, Bell KW. Exchanging dual-lumen central venous catheters: how I do it. Australas Radiol. 2007;51(2):106–9. Shimada M, Matsumata T, Wakiyama S, Maeda T, Kanematsu T, Sugimachi K. A safe and simple technique for exchanging central venous catheters. Postgrad Med J. 1993;69(808):139–40. Guttmann DM, Trerotola SO, Clark TW, Dagli M, Shlansky-Goldberg RD, Itkin M, et al. Malfunctioning and infected tunneled infusion catheters: over-the-wire catheter exchange versus catheter removal and replacement. J Vasc Interv Radiol. 2011;22(5):642–6, quiz 646. Beathard GA. Management of bacteremia associated with tunneled-cuffed hemodialysis catheters. J Am Soc Nephrol. 1999;10(5):1045–9. Robinson D, Suhocki P, Schwab SJ. Treatment of infected tunneled venous access hemodialysis catheters with guidewire exchange. Kidney Int. 1998;53(6):1792–4. Saran R, Li Y, Robinson B, Kevin AC, Lawrence YCA, John A, et al. US renal data system 2015 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis. 2016;67(3 Suppl 1):S1–S305. Wasse H, Kutner N, Zhang R, Huang Y. Association of initial hemodialysis vascular access with patient-reported health status and quality of life. Clin J Am Soc Nephrol. 2007;2(4):708–14. Poinen K, Quinn RR, Clarke A, Ravani P, Hiremath S, Miller LM, et al. Complications from tunneled hemodialysis catheters: a Canadian observational cohort study. Am J Kidney Dis. 2019;73(4):467–75. Jhee JH, Hwang SD, Song JH, Lee SW. The impact of comorbidity burden on the association between vascular access type and clinical outcomes among elderly patients undergoing hemodialysis. Sci Rep. 2019;9(1):18156. Santoro D, Benedetto F, Mondello P, Pipitò F, Barillà C, Spinelli V, et al. Vascular access for hemodialysis: current perspectives. Int J Nephrol Renovasc Dis. 2014;7:281–94. Masud A, Costanzo EJ, Zuckerman R, Asif A. The complications of vascular access in hemodialysis. Semin Thromb Hemost. 2018;44(1):57–9. Valliant AM, Chaudhry MK, Yevzlin AS, Astor B, Chan MR. Tunneled dialysis catheter exchange with fibrin sheath disruption is not associated with increased rate of bacteremia. J Vasc Access. 2015;16(1):52–6. Reddy AS, Lang EV, Cutts J, Loh S, Rosen MP. Fibrin sheath removal from central venous catheters: an internal snare manoeuvre. Nephrol Dial Transplant. 2007;22(6):1762–5. Tam-Tham H, Ravani P, Zhang J, Weaver RG, Quinn RR, James MT, et al. Association of initiation of dialysis with hospital length of stay and intensity of care in older adults with kidney failure. JAMA Netw Open. 2020;3(2):e200222. Article / Publication Details

First-Page Preview

Abstract of Hemodialysis – Research Article

Received: November 14, 2021
Accepted: May 27, 2022
Published online: July 06, 2022

Number of Print Pages: 10
Number of Figures: 11
Number of Tables: 3

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

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