Reinsertion of tunneled-cuffed central venous catheter
Abstract:
Purpose: Maintenance hemodialysis patients who rely on tunneled-cuffed catheters (TCCs) often face difficulty in reinserting a new catheter when the original catheter has been extruded or removed. Potential pathological changes of vessel caused by long-term indwelling of a catheter may contribute to this predicament. The aim of this study was to report and evaluate a re-catheterization technique through the same exit site and tunnel for hemodialysis patients with TCC loss.
Methods: A retrospective review of 19 patients with TCC loss was conducted from January 2020 to August 2022. These patients underwent reinsertion through the same exit site and subcutaneous existing tunnel. Procedure-related complications and clinical follow-up data were collected.
Results: All 19 patients with catheter loss underwent this procedure and the median duration of catheter loss was 14 days (5-57 days). Five of them had central venous occlusion, and four of them experienced catheter loss due to removal for catheter-related bloodstream infections (CRBI). In the end, 18 case received successful catheterization using this technique. The most common complication was minimal bleeding after the operation. There were no procedure-related deaths or serious complications. The average blood flow was 265.79 ± 25.89 ml/min at the end of the follow-up period.
Conclusion: This maneuver is a safe and convenient technique that can be used to reinsert a TCC for patients with long-time catheter loss. It helps to preserve the limited central venous resources for patients who have difficulty establishing other stable vascular access.
Reference:
Jin L, Zhao Q, Sun J, Cui T. Reinsertion of tunneled-cuffed catheter in hemodialysis patients with catheter loss and limited access options. J Vasc Access. 2024 Jan 12:11297298231224092. doi: 10.1177/11297298231224092. Epub ahead of print. PMID: 38217318.