Impact of short-term hemodialysis catheters on the central veins: a catheter venographic study

• Published in: European journal of radiology 2004-12, Vol.52 (3), p.293-299
• Main Authors: Oguzkurt, Levent, Tercan, Fahri, Torun, Dilek, Yildirim, Tülin, Zümrütdal, Aysegül, Kizilkilic, Osman
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood and lymphatic vessels; Brachiocephalic Veins - diagnostic imaging; Cardiology. Vascular system; Catheterization; Catheterization, Central Venous - instrumentation; Catheters, Indwelling; Central venous; Constriction, Pathologic - diagnostic imaging; Contrast Media; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Emergency and intensive care: renal failure. Dialysis management; Female; Fibrin; Foreign Bodies - diagnostic imaging; Hemodialysis; Humans; Intensive care medicine; Jugular Veins - diagnostic imaging; Male; Medical sciences; Middle Aged; Phlebography; Prospective Studies; Renal Dialysis - instrumentation; Sex Factors; Subclavian Vein - diagnostic imaging; Time Factors; Vena Cava, Superior - diagnostic imaging; Venous thrombosis; Venous Thrombosis - diagnostic imaging
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2003.12.004

Objective: To determine the incidence of pericatheter sleeve formation, thrombus formation, and stenosis of the central veins in hemodialysis patients with temporary catheters. Methods and material: In this prospective study, 57 patients (40 males, 17 females) with temporary dialysis catheters had catheter venography by pulling back the catheter just before removal. Patient’s age range was 25–87 years (mean age, 51 years). The venographic studies were evaluated for pericatheter sleeve formation, thrombus formation, and stenosis of the brachiocephalic vein (BCV) and the superior vena cava (SVC). The IJV could only be evaluated if there was adequate filling during contrast administration. In a subgroup of patients who had had only right IJV or only right SCV catheters, impact of these catheters on the central veins was compared. Results: The catheter location was right internal jugular vein (IJV) in 26 cases, right subclavian vein (SCV) in 27 cases, left IJV in 1 case, and left SCV in 3 cases. Thirty-two patients (56%) had had only one temporary catheter and the rest had had more than one inserted. The mean dwell time for the catheters was 21 days (range 7–59 days). A pericatheter sleeve was detected on venography in 32 (56%) patients and thrombus formation was noted in 16 patients (28%). A total of 41 patients (72%) exhibited pericatheter sleeve and/or thrombus formation. While 19 of the 32 patients (59%) without previous catheterization had a sleeve around the catheter, only 13 (52%) of 25 patients who had had multiple catheters inserted had a sleeve ( P>0.05). Of the eight patients (14%) with BCV stenosis, two had >50% stenosis. Only one patient (2%) had mild stenosis of the SVC. Three patients out of 15 (20%) who had diagnostic venography for the IJV had severe stenosis of the vein. Pericatheter sleeve formation was more frequent in women ( P