Early complications of translumbar cannulation of the inferior vena cava as a quick, last-chance method of gaining access for hemodialysis. Ten years of experience in one clinical center.

INTRODUCTION: The gold standard of vascular access for chronic hemodialysis patients is the arteriovenous fistula (AVF). If an AVF cannot be created, the hemodialysis catheter can be inserted into the internal jugular, femoral or subclavian vein. After exhausting the abovementioned standard accesses, translumbar access to the inferior vena cava (IVC) is considered a quick, last-chance and rescue method. AIM: Retrospective analysis of early complications (EC) of translumbar IVC catheterization using one type of catheter by one medical team. MATERIAL AND METHODS: From January 2010 to October 2019, a total of 34 translumbar IVC catheters were implanted in 27 patients. RESULTS: A major EC was found in 1 (2.9%) procedure. Minor EC occurred in 23.5 attempts. None of these complications required an intervention. CONCLUSIONS: In patients with exhausted possibilities of obtaining standard vascular access for HD, translumbar IVC cannulation proved to be a safe and effective method.

[Terminology concerning intravenous ports]. / Próba usystematyzowania terminologii dotyczacej portów dozylnych.

Ports are more and more often applied with patients requiring the permanent intravenous access, not only in the cancer treatment. Very devices, as well as procedures associated with applying them are determined in the heterogeneous way. Therefore during the last conference "Intravenous Port--implantation, care, complications" an attempt to systematize the applied terminology was made.

Percutaneous translumbar catheterization of the inferior vena cava as an emergency access for hemodialysis - 5 years of experience.

PATIENTS AND METHODS: In this study, 13 patients (11 men and 2 women) undergoing hemodialysis (HD) with the use of a catheter placed into the inferior vena cava with percutaneous translumbar access were retrospectively evaluated. In the studied group, 16 procedures of percutaneous translumbar catheterization were performed. Complications connected with the presence of catheter, such as hematoma, thrombosis, infection, catheter movement or unsuccessful catheterization, were analyzed. Moreover, another aspect of our report was to evaluate the adequacy of HD treatment performed by lumbar catheter. RESULTS: The total time of translumbar catheter observation was 4,169 days. Average time of their functioning was 261 days. The most frequent reason for termination of the use of translumbar HD catheters was spontaneous/idiopathic removal - 2 cases. Episodes of infection and thrombosis per 1,000 days of catheter observation were 2.2 and 1.2, respectively. CONCLUSIONS: Based on our study, we can conclude that correctly performed percutaneous translumbar catheterization of the inferior vena cava, in order to produce a long-term vascular access for HD, is a valuable and safe method in patients after depletion of standard vascular accesses.

Methods of central vascular access for haemodialysis.

The basic form of renal replacement therapy is haemodialysis. The duration and efficacy of this treatment depends on well-functioning vascular access. Short-term or long-term catheters are used if the arterial-venous fistula placement is not possible or not indicated. According to the recommendations of the NKF DOQI (National Kidney Foundation Disease Outcomes Quality Initiative), the first choice of access is the right internal jugular vein, and the next are the left internal jugular, femoral and subclavian vein. In this article, we present approaches to the abovementioned veins for haemodialysis cathether insertion as well as catheter tip positioning in the venous system to prevent serious complications.

Translumbar inferior vena cava cannulation.

BACKGROUND: The aim of the study was to review our three year experience with translumbar insertion of dialysis catheters. METHODS: In five adult patients (4 males and one female, mean age 45 yr), requiring dialysis due to end-stage chronic renal failure, the inferior vena cava was cannulated because of the impossibility of using any other approach. All procedures were performed under fluoroscopy. After visualisation of the inferior vena cava by injection of contrast medium into a peripheral vein, the vena cava was punctured with a 20 cm long needle, at the L3 level. The position of the needle was confirmed by injection of contrast medium, and the vein was then cannulated with a peel-away cannula, using a standard Seldinger technique. Subsequently, a pre-tunneled silastic catheter was introduced and secured. RESULTS: The catheters were used for from 3 to 10 months. No case of permanent catheter dysfunction was noted. Three episodes of temporary thrombosis, in two patients, were successfully treated with heparin and urokinase. Three catheters became contaminated, but they were treated without the necessity for catheter removal. CONCLUSION: The described method is a safe and effective way of securing haemodialysis access in patients where a standard approach is not possible.

[Translumbar cannulation of vena cava inferior as an alternative method of vascular access for hemodialysis]. / Przezledzwiowa kaniulacja zyly glównej dolnej jako alternatywny dostep naczyniowy do hemodializ.

The aim of our report is description of the first in Poland translumbar cannulation of vena cava inferior used as an alternative vascular access for hemodialysis in 62 years old patient without further access for hemodialysis and no access for peritoneal dialysis.