The journal of vascular access
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Hemodialysis-catheter dysfunction is a common clinical condition in nephrology. Like other central venous devices, hemodialysis-catheters show a disposition for partial or complete thrombotic obstruction and fibrin sleeve formation. ⋯ Those approaches show extremely variable results with mediocre long-term patency rates. Therefore, catheter-avoiding strategies should be considered in detail and AV-fistula creation preferred.
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The VenaTrac™ is designed for exchange and primary placement of chronic tunneled hemodialysis catheters over a wire. It occludes both lumens of the catheter for the purpose of reducing the risk of air embolism and blood loss. The purpose of this paper is to report our experience with the use of this device. ⋯ VenaTrac™ over-the-wire insertion device demonstrated safe and reliable use with no incidence of air embolism.
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Central venous catheters (CVCs) are widely used to create a temporary or long-term access to the central venous system. A variety of treatments require a functional central venous access, including hemodialysis, administration of drugs, plasmapheresis and parenteral nutrition. The aim of this study was to evaluate the results of CVC placement performed by surgical trainees, according to a strict protocol of ultrasound-guided puncture and fluoroscopy-guided catheter insertion in a large teaching hospital in an outpatient setting. ⋯ CVC placement by surgical trainees is a safe procedure when using a strict protocol of ultrasound-guided vessel puncture and fluoroscopic-guided catheter placement.