The establishment of hemodialysis access with long-term venous indwelling catheter under DSA guidance / 介入放射学杂志

ABSTRACT

Objective To discuss the management, complication and effectiveness of establishing a prolonged hemodialysis access with a long-term venous indwelling catheter. Methods During the penod of July 2007-February 2009, a total of 64 long-term venous indwelling catheters for hemodialysis were placed in 62 patients with terminal chronic renal insufficiency. Results Of the total 64 catheter-placements, 62 were pereformed under DSA guidance and 2 at bed-side. Because of blocked flow, adjustment of the catheter was carried out in 4 cases, replacement of catheter in 2 cases and thrombolytic therapy in one case. In 62 patients, the arterial flow rate after the procedure reached to 230-300ml/min. In 57 cases the indwelling catheter remained in working condition so far. Five cases died within 6 months. Conclusion For establishing a prolonged hemodialysis access. The placement of a long-term venous indwelling catheter is feasible. The main complication is the blocked flow. Which is mainly related to the disposition of the catheter itself or its tip. The right intemal jugular vein is the indwelling site of choice, the tip of double-lumen catheter should be within the superior vein cava. With the help of DSA guidance, the procedure can be performed accurately, safely and easily.