The Tunnelled Atrial Catheter: A Promising Solution for Vascular Capital Depletion in Dialysis despite Associated Thrombi.

Case Reports in Nephrology Pub Date : 2024-03-15 eCollection Date: 2024-01-01 DOI:10.1155/2024/5219914
Meriam Hajji, Salah Saied, Ikram Mami, Yassine Khadhar, Tasnim Ben Ayed, Imen Gorsane, Fethi Ben Hamida, Jalel Ziadi, Mohamed Karim Zouaghi, Ezzeddine Abderrahim
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Abstract

Introduction: Longer survival in dialysis led to a higher incidence of vascular access complications and failure. With the limited access to kidney transplantation programs and peritoneal dialysis, exhaustion of vascular access for hemodialysis is an increasingly common situation. Among the available options, atrial tunneled dialysis catheter (ATDC) has been reported as an effective vascular access in this population. Methodology. We report the experiences of two nephrology centers in Tunis with ATDC as an ultimate vascular access for dialysis. Case Reports. Two patients with exhausted vasculature underwent ATDC insertion in 2020 and 2022, respectively, as a vascular access of last resort. Both patients underwent CRBI, which resolved with favorable outcomes. One case was complicated by post-operative thrombosis and was successfully treated with thrombolysis. Both patients are currently on dialysis via their ATDC with a catheter patency of 29 months.

Conclusion: ATDC is a life-saving and safe vascular access in cases of depleted vasculature. Little more than 50 cases have been reported in the literature during the last 30 years. As the frequency of vasculature exhaustion is expected to increase, preservation of veinous access in patients at risk of chronic kidney disease have never been more crucial.

隧道式心房导管:尽管伴有血栓,但仍是透析中血管资本消耗的理想解决方案。
导言:透析存活时间的延长导致血管通路并发症和失败的发生率增加。由于肾移植计划和腹膜透析的机会有限,血液透析血管通路枯竭的情况越来越常见。据报道,在现有选择中,心房隧道透析导管(ATDC)是此类人群的有效血管通路。方法。我们报告了突尼斯两家肾脏病中心使用 ATDC 作为透析最终血管通路的经验。病例报告。两名血管衰竭患者分别于 2020 年和 2022 年接受了 ATDC 植入术,作为最后的血管通路。两名患者均接受了 CRBI,结果良好。其中一例患者因术后血栓形成而并发症,成功接受了溶栓治疗。这两名患者目前都在通过 ATDC 进行透析,导管通畅时间长达 29 个月:结论:ATDC 是一种挽救生命的安全血管通路,适用于血管衰竭的病例。过去 30 年中,文献报道的病例不超过 50 例。由于血管衰竭的发生率预计会越来越高,因此为有慢性肾病风险的患者保留静脉通路从未像现在这样重要。
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来源期刊
Case Reports in Nephrology
Case Reports in Nephrology Medicine-Nephrology
CiteScore
1.70
自引率
0.00%
发文量
32
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