Transcutaneous intravascular transposition of a permanent dialysis catheter

Abstract

Permanent catheters are used to provide long-lasting access for long-term dialysis therapy in certain patients when creating an arteriovenous fistula between their own vessels is not possible, when there are contraindications for fistula creation or when the expected lifetime of the patient is short. We present the case of a patient with terminal renal insufficiency treated with hemodialysis for 5 years. Due to post-thrombotic changes and venous stenosis resulting from long-term cannulation with dialysis catheters, the replacement catheter was inserted through the previously used canal and transcutaneous intravascular catheter transposition was performed.

Keywords: endovascular catheter transposition; hemodialysis; permanent catheters.

Photo 1

All stages of dialysis catheter transposition (for a more detailed description, see the text): A – The port end was positioned in the distal part of the obstructed left brachiocephalic vein. B – Confirmation of the port patency. C – Introduction of the “J” guide wire into the right atrium and the loop from the right femoral vein access. D, E – Port transposition into the right atrium. F – Confirmation of the patency of the dialysis catheter