Volume 20 Issue 1
Jan.  2022
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Article Navigation >  Chinese Journal of General Practice  > 2022  >  20(1): 72-75
LIU Man-man, XU Li-yun, WANG Sha-sha, CHEN De-jun. Clinical application of central venous percutaneous transluminal angioplasty in the replacement of tunnel-cuffed catheter[J]. Chinese Journal of General Practice, 2022, 20(1): 72-75. doi: 10.16766/j.cnki.issn.1674-4152.002280
Citation: LIU Man-man, XU Li-yun, WANG Sha-sha, CHEN De-jun. Clinical application of central venous percutaneous transluminal angioplasty in the replacement of tunnel-cuffed catheter[J]. Chinese Journal of General Practice, 2022, 20(1): 72-75. doi: 10.16766/j.cnki.issn.1674-4152.002280
shu

Clinical application of central venous percutaneous transluminal angioplasty in the replacement of tunnel-cuffed catheter

doi: 10.16766/j.cnki.issn.1674-4152.002280

  • Department of Nephrology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China

Funds:

 2020ZH072

 20EZC36

  • Received Date: 2020-08-07
    Available Online: 2022-03-03
    Abstract
  •   Objective  To investigate the clinical application of percutaneous transluminal angioplasty (PTA) in catheter replacement of haemodialysis patients with catheter-related central vein disease.  Methods  Clinical data were collected from 10 patients admitted to the Taizhou Hospital of Zhejiang Province between January 2018 and December 2019 with catheter-related central venous disease and vascular access requiring tunnel-cuffed catheter (TCC). All patients underwent angiography to determine the narrow area, extent, degree of the narrow central veins, underwent PTA treatment, and then placed into the new TCC, followed-up 3 to 6 months to observe the patient's clinical efficacy.  Results  After dilation, the central-vein stenosis significantly improved in all patients compared with the previous. New TCC was successfully replaced, and no surgically related complications occurred, such as arrhythmic disorder, cardiac tamponade, balloon rupture, and catheter through the central vein into the mediastinum or chest resulting in haemothorax, haemopneumothorax, mediastinal hematoma, and other complications. Postoperative X-ray showed satisfactory catheter position. Immediately after the operation, catheters were used for haemodialysis, and blood flow reached 250 mL/min observed five times. The patients were followed up for 3-6 months after the operation. Catheter blood flow during dialysis reached 250 mL/min in all patients, and no catheter dysfunction or infection occurred.  Conclusion  When patients take TCC as a long-term vascular access and continued use of the original TCC is not possible, angiography should be performed. If there is serious central-vein stenosis, it would be safer to replace the new TCC after PTA treatment with a high success rate. This study provides a new idea for the clinical establishment of vascular access in such patients.

     

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