Journal of Vascular Access最新文献

{"title":"Intracavitary electrocardiogram guidance for peripherally inserted central catheter placement: A systematic review and trial sequential meta-analysis.","authors":"Mao Zhou, Wen-Li Zeng, Charles Damien Lu, Ming-Wei Sun, Hua Jiang","doi":"10.1177/11297298251334889","DOIUrl":"https://doi.org/10.1177/11297298251334889","url":null,"abstract":"<p><strong>Background: </strong>The intracavitary electrocardiogram (IC-ECG) localization technique has been widely used in peripherally inserted central catheter (PICC) placement. However, the accuracy of IC-ECG on PICC tip localization and complications remains controversial. The purpose of this work is to evaluate the clinical efficacy and safety of IC-ECG on PICC placement.</p><p><strong>Materials and method: </strong>We retrieved randomized control trials from PubMed, Web of Science, Cochrane Library, EMBASE, and CNKI databases published before October 30, 2024. Patients guided by IC-ECG technology or landmark, and then used radiography to confirm the tip position, regardless of age, race, nationality, and region. Interventions other than IC-ECG or landmark were excluded. We used the Cochrane Bias Risk Assessment tools version 2 to evaluate the quality of enrolled trials. The Grading of Recommendations Assessment, Development, and Evaluation Statements online tool was used to determine the certainty of the evidence. The primary outcome was the success rate on the first attempt.</p><p><strong>Results: </strong>Sixteen studies involving 6707 PICC patients are included. The results of the meta-analysis indicate that the IC-ECG group has a significantly higher success rate on first attempt of PICC placement (RR = 1.23, 95% CI [1.09-1.37], <i>p</i> < 0.00001). Total complications and phlebitis events decreased in the IC-ECG group compared with the landmark group. The mean procedure time, thrombogenesis, infection, and arrhythmia in the IC-ECG group are not statistically significant compared with the landmark group. Trial-sequential analysis (TSA) of the results indicate that sufficient events had been observed in the outcomes in success rate on first attempt, overall successful rate, total complications, phlebitis events, and infection events.</p><p><strong>Conclusion: </strong>The IC-ECG guided method has a higher success rate on the first attempt and lower total complication for catheter tip localization in PICC placement. IC-ECG may be considered the preferred method for accurate catheter tip placement. (PROSPERO registration number, CRD42023456651).</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251334889"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Italian expert consensus on the choice of the method of tip location for central venous access devices.","authors":"Vincenzo Faraone, Mauro Pittiruti, Maria Giuseppina Annetta, Giovanni Barone, Fabrizio Brescia, Maria Calabrese, Antonella Capasso, Giuseppe Capozzoli, Vito D'Andrea, Sonia D'Arrigo, Daniele Elisei, Stefano Elli, Igor Giarretta, Antonio Gidaro, Davide Giustivi, Emanuele Iacobone, Rossella Mastroianni, Fulvio Pinelli, Giancarlo Scoppettuolo, Ferdinando Spagnuolo, Geremia Zito Marinosci, Gilda Pepe, Daniele G Biasucci","doi":"10.1177/11297298251336809","DOIUrl":"https://doi.org/10.1177/11297298251336809","url":null,"abstract":"<p><p>Tip location of central venous access devices is considered highly relevant for the purpose of reducing catheter-related complications and prolong the duration of the access. Though, the choice of the method of tip location currently relies upon the operator's experience, preference, and training, on the local availability of specific resources and technologies, and on local policies. On the contrary, considering the relevance of tip location, such clinical choice should preferably be based on the best available evidence. Though current guidelines recommend intra-procedural rather than post-procedural methods of tip location, many clinicians still adopt the strategy of assessing the position of the tip by radiological methods after the completion of the procedure. Also, though current guidelines and evidence-based documents recommend the intra-cavitary electrocardiography and/or trans-thoracic echocardiography as preferred methods of intraprocedural tip location, many clinicians still adopt fluoroscopy. While the pros and cons of each different method of tip location are well known, there is no evidence-based document that offer robust recommendations about the choice of tip location of different central venous access devices in different population of patients (neonates, children, adults). Therefore, the Italian Group of Long-Term Venous Access Devices (GAVeCeLT) and the Italian Vascular Access Society (IVAS) have developed a national consensus on the choice of the most appropriate method of tip location. After a systematic review of the available evidence, the panel of the consensus (which included 22 Italian experts with documented competence in this area) has provided structured recommendations answering six key questions regarding the choice between intra-procedural and post-procedural tip location, as well as the appropriate indication of the four different methods of intra-procedural tip location currently available (trans-esophageal echocardiography, trans-thoracic echocardiography, intracavitary electrocardiography, and fluoroscopy). Only statements reaching a 100% agreement were included in the final recommendations.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251336809"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cavoatrial junction stenting in vascular hemodialysis catheter malfunction.","authors":"Federico Francisco Pennetta, Massimiliano Millarelli, Francesco De Santis, Alessandra Bandiera, Matteo Tozzi, Roberto Chiappa","doi":"10.1177/11297298241250372","DOIUrl":"10.1177/11297298241250372","url":null,"abstract":"<p><p>In patients undergoing hemodialytic treatment via intravascular catheters, stenosis or occlusion of central veins is common. Despite an extensive characterization of Superior Vena Cava Syndrome (SVCS) no data is available about CavoAtrial Junction (CAJ) stenosis. We report the case of two patients with a story of multiple catheter failures due to thrombosis or infection. Computed tomography (CT) showed radiological signs of CAJ stenosis confirmed at the following venography. In absence of other feasible options to place a vascular access, the two underwent stenting with Gore Viabahn VBX balloon expandable endoprosthesis (W.L. Gore & Associates, Flagstaff, AZ, USA) of the CAJ stenosis. Completion venography showed complete resolution of the stenosis in both patients. No complications occurred during the procedures. At a mean follow-up of 878 ± 559 days no signs of in-stent restenosis or recoil were found. The present cases emphasize the feasibility and safety of CAJ stenting, underlining the importance of preserving CAJ and upper veins patency in hemodialysis access.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1041-1045"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Totally implanted central venous access devices inserted by the femoral route: A narrative review and the proposal of a novel approach, the FICC-port.","authors":"Maria Giuseppina Annetta, Bruno Marche, Gloria Ortiz Miluy, Mauro Pittiruti","doi":"10.1177/11297298241236816","DOIUrl":"10.1177/11297298241236816","url":null,"abstract":"<p><strong>Background: </strong>Femoral ports are used in patients with indication to a totally implanted venous access device but with contraindication to chest-ports and brachial ports because of obstruction of the superior vena cava. In the last three decades, femoral ports have been implanted almost exclusively by cannulation of the common femoral vein at the groin, while the position of the tip has been assessed by X-ray.</p><p><strong>Methods: </strong>We report our experience with a new approach to femoral ports, which includes recent methods and techniques developed in the last few years. These novel femoral ports, which we call \"FICC-ports,\" are characterized by (a) long femoral 5 Fr polyurethane catheter inserted by ultrasound-guided puncture of the superficial femoral vein at mid-thigh; (b) intraprocedural location of the tip in the sub-diaphragmatic inferior vena cava, using ultrasound visualization by the transhepatic and/or the subcostal view; (c) low-profile or very low-profile reservoir implanted above the quadriceps muscle, at mid-thigh.</p><p><strong>Results: </strong>In the last 3 years, we have implanted 47 FICC-ports in young adults with mediastinal lymphoma compressing the superior vena cava. We had no immediate/early complication, and only three late complications (one kinking of the catheter in the subcutaneous tissue; one tip migration with secondary venous thrombosis; one persistent withdrawal occlusion due to fibroblastic sleeve).</p><p><strong>Conclusion: </strong>If there is indication to a femoral port, the implantation of a \"FICC-port\"-as described above-is to be strongly considered in terms of safety, effectiveness, and cost-effectiveness: no immediate-early complications, minimal late complications, no X-ray exposure, low invasiveness, low cost.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"871-879"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The pediatric DAV-expert algorithm: A GAVeCeLT/GAVePed consensus for the choice of the most appropriate venous access device in children.","authors":"Mauro Pittiruti, Alessandro Crocoli, Clelia Zanaboni, Maria Giuseppina Annetta, Michela Bevilacqua, Daniele G Biasucci, Davide Celentano, Simone Cesaro, Antonio Chiaretti, Nicola Disma, Aldo Mancino, Cristina Martucci, Lidia Muscheri, Alessio Pini Prato, Alessandro Raffaele, Simone Reali, Francesca Rossetti, Giancarlo Scoppettuolo, Luca Sidro, Geremia Zito Marinosci, Gilda Pepe","doi":"10.1177/11297298241256999","DOIUrl":"10.1177/11297298241256999","url":null,"abstract":"<p><p>In pediatric patients, the choice of the venous access device currently relies upon the operator's experience and preference and on the local availability of specific resources and technologies. Though, considering the limited options for venous access in children if compared to adults, such clinical choice has a great critical relevance and should preferably be based on the best available evidence. Though some algorithms have been published over the last 5 years, none of them seems fully satisfactory and useful in clinical practice. Thus, the GAVePed-which is the pediatric interest group of the most important Italian group on venous access, GAVeCeLT-has developed a national consensus about the choice of the venous access device in children. After a systematic review of the available evidence, the panel of the consensus (which included Italian experts with documented competence in this area) has provided structured recommendations answering 10 key questions regarding the choice of venous access both in emergency and in elective situations, both in the hospitalized and in the non-hospitalized child. Only statements reaching a complete agreement were included in the final recommendations. All recommendations were also structured as a simple visual algorithm, so as to be easily translated into clinical practice.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"715-725"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overview of the distal radial access from the radial artery occlusion perspective.","authors":"Alexander Vladimirovich Korotkikh, Maksim Gennadievich Kashtanov","doi":"10.1177/11297298241250376","DOIUrl":"10.1177/11297298241250376","url":null,"abstract":"<p><p>Conventional radial access in endovascular surgery has certain limitations, primarily associated with the presence of local complications and radial artery occlusion. Over the past 7 years, distal radial access has exploded into all areas of endovascular procedures, from interventional cardiology to vascular surgery and interventional oncology. However, puncture of the distal radial artery has its own nuances and features: a learning curve, the use of ultrasound navigation in the initial stages of mastering the access, limitations in patients with acute conditions (acute coronary syndrome and stroke). This review aims to analyze on important aspects of the procedure of distal radial access from preparation for it to hemostasis and to explore all data about the new roles of distal radial access in avoiding but also treating radial artery occlusion, as the first thing to begin with the development and implementation of new access.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"747-755"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed onset skin toxicity reaction after peripherally inserted central catheter rupture in lower extremities combined with chemotherapy.","authors":"Tian Tian, Yang Liu, Lin Tan","doi":"10.1177/11297298241254640","DOIUrl":"10.1177/11297298241254640","url":null,"abstract":"<p><p>Herein, we present a patient who was undergoing chemotherapy for bilateral breast cancer and experienced delayed-onset skin toxicity reactions after rupture of a peripherally inserted central catheter (PICC) in the lower extremities. The objective of this case report is to provide the necessary nursing assessment for the risk awareness of the PICC internal rupture and the occurrence of central venous catheter extravasation, as well as to strengthen the judgment of delayed skin toxicity of chemotherapeutic drugs. Rupture of the PICC in the lower extremities was primarily attributed to the use of a silicone catheter and an excessive puncture angle. The nature of docetaxel and partial catheter rupture caused drug extravasation, leading to delayed skin toxicity. The use of a polyurethane catheter reduces the incidence of catheter rupture; hence, silicon catheters should be avoided. The central venous catheter is also at risk for the extravasation of chemotherapeutic agents. Moreover, docetaxel-induced delayed skin toxicity, which has a high incidence, should be treated as expected. Nurses and clinicians should be aware of PICC internal rupture and central venous catheter extravasation to strengthen the judgment of delayed skin toxicity of chemotherapeutic drugs.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1055-1058"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141156021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the outcome of a bundle with 11 components and the INICC multidimensional approach in decreasing rates of central line-associated bloodstream infections across nine Asian countries.","authors":"Victor Daniel Rosenthal, Ruijie Yin, Sheila Nainan Myatra, Jigeeshu Vasishth Divatia, Sanjay K Biswas, Anjana Mahesh Shrivastava, Valentina Perez, Qi Yuee Wang, Subhash Kumar Todi, Swee Fong Tang, Chian Wern Tai, Pei-Chuen Lee, Deep Sengupta, Smita Sarma, Kavita Sandhu, Camilla Rodrigues, Bikas Nag, Mat Nor Mohd-Basri, Yatin Mehta, Mohit Kharbanda, Sudha Kansal, Aakanksha Chawla Jain, Narangarav Davaadagva, Soo Lin Chuah, Michelle Siu Yee Low, Chin Seng Gan, Marissa Bt Madzlan Kushairi, Mahuya Bhattacharyya, Arpita Bhakta, Tsolmon Begzjav, Batsuren Bat-Erdene, Roseleen Kaur Bali, Binesh Badyal, Ankush Arora, Rajalakshmi Arjun, Lili Tao, Zhilin Jin, Rajesh Chawla","doi":"10.1177/11297298241242163","DOIUrl":"10.1177/11297298241242163","url":null,"abstract":"<p><strong>Background: </strong>Central line-associated bloodstream infection (CLABSI) rates in intensive care units (ICUs) across Latin America exceed those in high-income countries significantly.</p><p><strong>Methods: </strong>We implemented the INICC multidimensional approach, incorporating an 11-component bundle, in 122 ICUs spanning nine Asian countries. We computed the CLABSI rate using the CDC/NSHN definition and criteria. The CLABSI rate per 1000 CL-days was calculated at baseline and throughout different phases of the intervention, including the 2nd month, 3rd month, 4-16 month, and 17-29 month periods. A two-sample <i>t</i>-test was employed to compare baseline CLABSI rates with intervention rates. Additionally, we utilized a generalized linear mixed model with a Poisson distribution to analyze the association between exposure and outcome.</p><p><strong>Results: </strong>A total of 124,946 patients were hospitalized over 717,270 patient-days, with 238,595 central line (CL)-days recorded. The rates of CLABSI per 1000 CL-days significantly decreased from 16.64 during the baseline period to 6.51 in the 2nd month (RR = 0.39; 95% CI = 0.36-0.42; <i>p</i> < 0.001), 3.71 in the 3rd month (RR = 0.22; 95% CI = 0.21-0.25; <i>p</i> < 0.001), 2.80 in the 4-16 month (RR = 0.17; 95% CI = 0.15-0.19; <i>p</i> < 0.001), and 2.18 in the 17-29 month (RR = 0.13; 95% CI = 0.11-0.15; <i>p</i> < 0.001) intervals. A multilevel Poisson regression model demonstrated a sustained, continuous, and statistically significant decrease in ratios of incidence rates, reaching 0.35 (<i>p</i> < 0.0001) during the 17-29 month period. Moreover, the all-cause in-ICU mortality rate significantly decreased from 13.23% to 10.96% (<i>p</i> = 0.0001) during the 17-29 month period.</p><p><strong>Conclusions: </strong>Our intervention led to an 87% reduction in CLABSI rates, with a 29-month follow-up.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"762-771"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140308053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of volume flow rate in arteriovenous fistulas with a novel ultrasound Doppler device (earlybird): Trend analysis, comparison of methods, and inter- and intra-rater reliability.","authors":"Emilie Holst-Jæger, Marthe Barstad, Øyvind Salvesen, Hans Torp, Arne Seternes, Erik Mulder Pettersen","doi":"10.1177/11297298241250379","DOIUrl":"10.1177/11297298241250379","url":null,"abstract":"<p><strong>Background: </strong>An accessible tool is required to analyze volume flow trends in arteriovenous fistulas for hemodialysis. Earlybird, an easy-to-place ultrasound Doppler device, has shown comparable accuracy to duplex ultrasound. In this study, we compared volume flow measurements obtained with duplex ultrasound and the dilution technique to an enhanced earlybird device, featuring a dual Doppler probe system, eliminating the requirement for a known insonation angle.</p><p><strong>Methods: </strong>Nine patients with a distal radiocephalic arteriovenous fistula were monitored for 12 months with regular volume flow measurements. Correlation and inter- and intra-class reliability analyses were conducted.</p><p><strong>Results: </strong>An overall moderate correlation was observed between earlybird and duplex ultrasound or dilution technique (intraclass correlation coefficient = 0.606 (95% confidence interval 0.064, 0.721) and 0.581 (0.039, 0.739), respectively). Duplex ultrasound compared to dilution measurements, demonstrated an overall moderate correlation (0.725 (0.219, 0.843)). Correlation between earlybird and duplex ultrasound was stronger for the arteriovenous fistula (0.778 (0.016, 0.901)) than the brachial artery (0.381 (-0.062, 0.461)). For earlybird, inter-rater reliability was excellent for the arteriovenous fistula (0.907 (0.423, 0.930)) and poor for the brachial artery (0.430 (0.241, 0.716)). Duplex ultrasound showed a good inter-rater reliability (arteriovenous fistula: 0.843 (0.610, 0.871), brachial artery: 0.819 (0.477, 0.864)). The overall intra-rater reliability was good for duplex ultrasound (rater A: 0.893 (0.727, 0.911); rater B: 0.853 (0.710, 0.891)), while excellent for earlybird (rater A: 0.905 (0.819, 0.928); rater B: 0.921 (0.632, 0.969)).</p><p><strong>Conclusion: </strong>We observed a weaker correlation in the measurements of volume flow rates in arteriovenous fistulas when obtained using earlybird compared to dilution technique, unlike the comparison between duplex ultrasound and the dilution technique. However, inter-rater reliability for the arteriovenous fistula was excellent with earlybird and good with duplex ultrasound, indicating the potential of earlybird as a tool for frequent measurements, enabling trend surveillance and predicting adverse outcomes.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"862-870"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of some uncommon but significant complications of the tunneled cuffed catheter for hemodialysis.","authors":"Xue Jing Lin, Qi Yan Nan, Shang Guo Piao, Ji Zhe Jin, Can Li","doi":"10.1177/11297298251333875","DOIUrl":"https://doi.org/10.1177/11297298251333875","url":null,"abstract":"<p><p>Although use of the autogenous arteriovenous fistula is the first choice for vascular access for hemodialysis, the tunneled cuffed catheter (TCC) remains an important alternative method that is applied widely in maintenance hemodialysis for patients with end-stage renal disease. In addition to common complications, such as thrombosis, infection, formation of a fibrin sheath, or central vein stenosis, TCC dysfunction, such as kinks, cuff detachment, or mechanical destruction, can be easily overlooked. The reasons for these clinical problems are multifactorial and include the insertion handling, presence of diabetes mellitus, catheter type, malnutrition, and the patient's body habitus. This minireview describes our experience with TCC and the current literature on managing TCC dysfunction.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251333875"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}