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< Vol. 15 Suppl. 7 | May 2014 | Presentations of the European Vascular Access Course 2014

Complex central venous catheter insertion for hemodialysis

Complex central venous catheter insertion for hemodialysis

J Vasc Access 2014; 15(Suppl. 7): 136 - 139

Article Type: ORIGINAL ARTICLE

Article Subject: EVC 2014

DOI:10.5301/jva.5000250

Authors

Steven Powell, Jane Belfield

Abstract

Despite the introduction of payment by results in the UK, there has been no decrease in central venous catheter (CVC) use. In part, this may relate to a requirement to dialyse through a CVC while autogenous access matures. Mortality data have improved in parallel and patients on hemodialysis live longer, which may lead to an increased exposure to CVCs.

Exposure to CVCs carries a significant risk of infection and occlusion requiring their repositioning or exchange. The mid to long-term sequelae of CVC use is central venous occlusion leaving clinical teams with an ever increasing challenge to find adequate venous access.

In this article, we will discuss the challenges faced by operators inserting CVCs into the hemodialysis-dependent patient who has exhausted more tradition insertion sites. These include translumbar caval catheters, transocclusion and transcollateral catheters, transjugular Inferior Vena Cava catheter postioning, and transhepatic catheters. We will demonstrate the techniques employed, complications, and anticipated longevity of function.

Article History

  • • Accepted on 05/03/2014
  • • Available online on 18/04/2014
  • • Published in print on 01/05/2014

Disclosures

Financial support: The authors have no financial disclosures to make.
Conflict of interest: The authors have no conflict of interest.

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Authors

  • Powell, Steven [PubMed] [Google Scholar] , * Corresponding Author (steve.jspracing@yahoo.co.uk)
  • Belfield, Jane [PubMed] [Google Scholar]

Affiliations

  • Royal Liverpool Hospital, Liverpool, Merseyside - UK

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