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. 2023 Mar;36(2):359-365.
doi: 10.1007/s40620-022-01474-y. Epub 2022 Oct 21.

Report on an Italian survey of 72 stuck hemodialysis catheters

Giacomo Forneris  1 , Daniele Savio  2 , Pietro Quaretti  3 , Massimo Lodi  4 , Simone Comelli  5 , Walter Morale  6 , Monica Spina  7 , Luca Di Maggio  2 , Marina Cornacchiari  8 , Massimo Punzi  9 , Giuseppe Gatta  10 , Pasqualina Cecere  11 , Marco Pozzato  11 , Antonio Marciello  12 , Dario Roccatello  11 ; Vascular Access Study Project Group of the Italian Society of Nephrology
Collaborators, Affiliations

Report on an Italian survey of 72 stuck hemodialysis catheters

Giacomo Forneris et al. J Nephrol. 2023 Mar.

Abstract

Background: Reports of stuck hemodialysis catheters have been on the rise in recent years. Aim of this work is to report how this complication has been managed and the relative outcomes in a multicente Italian survey.

Methods: Since 2012, the Italian Society of Nephrology (SIN) Project Group of Vascular Access has collected data among nephrologists on this complication. Data regarding 72 cases of stuck tunnelled central venous catheter (tCVC) in 72 patients were retrieved thanks to this survey.

Results: In 11 patients (15%) the stuck catheter was directly buried or left in place. Sixty-one cases were managed through advanced removal techniques. Among these, 47 (77%) stuck tunnelled central venous catheters were successfully removed, while 14 (23%) failed to be withdrawn. Considering removed tCVCs, the use of endoluminal balloon dilatation alone or in combination with other tools showed a percentage of success of 88%. The removal procedure involved numerous specialists. Some complications occurred, such as breakage of the line or bleeding, and two cases of haemopericardium during an advanced procedure.

Conclusion: The survey shows how the stuck catheter complication was managed in different ways, with conflicting results. When utilized, endoluminal balloon dilatation proved to be the most effective and most often utilized technique, while some cases had suboptimal management or failure. This underlines how delicate the procedure is, and the need for both precise knowledge of this complication and timely organization of removal attempts.

Keywords: Embedded; Haemodialysis; Retention; Stuck catheter; Tunnelled catheters; Vascular access.

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