Emergent Hemodialysis Access: Balloon Venoplasty and Tunneled Catheter Placement in Patients with Exhausted Venous Access – Evaluation of Safety and Patency Determinants

Mustafa Mazıcan; İsmail Karluka

Makale detayları

Emergent Hemodialysis Access: Balloon Venoplasty and Tunneled Catheter Placement in Patients with Exhausted Venous Access – Evaluation of Safety and Patency Determinants

Yazarlar:

Mustafa Mazıcan | İsmail Karluka

Yayıncı:

Sakarya University

Ana Başlıklar:

Radyoloji ve Organ Görüntüleme

Dergi:

Sakarya Tıp Dergisi Vol.15 Issue 3, pp.288-298

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001358012

pISSN:

2146-409X

Anahtar kelimeler:

Özet:

 BackgroundObjectives: Central venous occlusion CVO presents a significant challenge in providing emergency hemodialysis to patients with end-stage renal disease ESRD. This study evaluated the feasibility, safety, and effectiveness of percutaneous transluminal balloon venoplasty to restore central venous patency and enable tunneled hemodialysis catheter placement in patients with complete CVO. This study specifically focused on patients with complete occlusion of all central venous pathways, a rare and underreported scenario in the literature. Methods: This retrospective, single-center observational study included 50 dialysis patients with confirmed occlusion of all central veins between November 2015 and September 2024. Balloon venoplasty was performed to recanalize the occluded veins, followed by the placement of a catheter. Patients were monitored for catheter patency and complications, and predictors of catheter dysfunction were analyzed. Results: A 100 technical success rate was achieved. The mean primary patency duration was 4 months range: 137 months. Catheter dysfunction occurred in 11 patients 22, primarily due to infection or occlusion. Multivariable analysis identified catheter distal tip location as the sole predictor of dysfunction OR: 0.146, 95 CI: 0.0260.816, p  0.028. Catheters with tips in the right atrium demonstrated better patency than those in the inferior vena cava. Minor complications included hematomas 11.3 and arrhythmias 16.1. Conclusions: Balloon venoplasty is a safe and effective technique for managing patients with exhausted central venous access, providing emergency hemodialysis, and acting as a bridge to definitive solutions such as AV fistulas, peritoneal dialysis, or renal transplantation. To optimize patency and reduce the risk of dysfunction, catheter tips are recommended to be placed in the right atrium. Further research is needed to refine this approach and extend access longevity.

 BackgroundObjectives: Central venous occlusion CVO presents a significant challenge in providing emergency hemodialysis to patients with end-stage renal disease ESRD. This study evaluated the feasibility, safety, and effectiveness of percutaneous transluminal balloon venoplasty to restore central venous patency and enable tunneled hemodialysis catheter placement in patients with complete CVO. This study specifically focused on patients with complete occlusion of all central venous pathways, a rare and underreported scenario in the literature. Methods: This retrospective, single-center observational study included 50 dialysis patients with confirmed occlusion of all central veins between November 2015 and September 2024. Balloon venoplasty was performed to recanalize the occluded veins, followed by the placement of a catheter. Patients were monitored for catheter patency and complications, and predictors of catheter dysfunction were analyzed. Results: A 100 technical success rate was achieved. The mean primary patency duration was 4 months range: 137 months. Catheter dysfunction occurred in 11 patients 22, primarily due to infection or occlusion. Multivariable analysis identified catheter distal tip location as the sole predictor of dysfunction OR: 0.146, 95 CI: 0.0260.816, p  0.028. Catheters with tips in the right atrium demonstrated better patency than those in the inferior vena cava. Minor complications included hematomas 11.3 and arrhythmias 16.1. Conclusions: Balloon venoplasty is a safe and effective technique for managing patients with exhausted central venous access, providing emergency hemodialysis, and acting as a bridge to definitive solutions such as AV fistulas, peritoneal dialysis, or renal transplantation. To optimize patency and reduce the risk of dysfunction, catheter tips are recommended to be placed in the right atrium. Further research is needed to refine this approach and extend access longevity.

 BackgroundObjectives: Central venous occlusion CVO presents a significant challenge in providing emergency hemodialysis to patients with end-stage renal disease ESRD. This study evaluated the feasibility, safety, and effectiveness of percutaneous transluminal balloon venoplasty to restore central venous patency and enable tunneled hemodialysis catheter placement in patients with complete CVO. This study specifically focused on patients with complete occlusion of all central venous pathways, a rare and underreported scenario in the literature. Methods: This retrospective, single-center observational study included 50 dialysis patients with confirmed occlusion of all central veins between November 2015 and September 2024. Balloon venoplasty was performed to recanalize the occluded veins, followed by the placement of a catheter. Patients were monitored for catheter patency and complications, and predictors of catheter dysfunction were analyzed. Results: A 100 technical success rate was achieved. The mean primary patency duration was 4 months range: 137 months. Catheter dysfunction occurred in 11 patients 22, primarily due to infection or occlusion. Multivariable analysis identified catheter distal tip location as the sole predictor of dysfunction OR: 0.146, 95 CI: 0.0260.816, p  0.028. Catheters with tips in the right atrium demonstrated better patency than those in the inferior vena cava. Minor complications included hematomas 11.3 and arrhythmias 16.1. Conclusions: Balloon venoplasty is a safe and effective technique for managing patients with exhausted central venous access, providing emergency hemodialysis, and acting as a bridge to definitive solutions such as AV fistulas, peritoneal dialysis, or renal transplantation. To optimize patency and reduce the risk of dysfunction, catheter tips are recommended to be placed in the right atrium. Further research is needed to refine this approach and extend access longevity.

 BackgroundObjectives: Central venous occlusion CVO presents a significant challenge in providing emergency hemodialysis to patients with end-stage renal disease ESRD. This study evaluated the feasibility, safety, and effectiveness of percutaneous transluminal balloon venoplasty to restore central venous patency and enable tunneled hemodialysis catheter placement in patients with complete CVO. This study specifically focused on patients with complete occlusion of all central venous pathways, a rare and underreported scenario in the literature. Methods: This retrospective, single-center observational study included 50 dialysis patients with confirmed occlusion of all central veins between November 2015 and September 2024. Balloon venoplasty was performed to recanalize the occluded veins, followed by the placement of a catheter. Patients were monitored for catheter patency and complications, and predictors of catheter dysfunction were analyzed. Results: A 100 technical success rate was achieved. The mean primary patency duration was 4 months range: 137 months. Catheter dysfunction occurred in 11 patients 22, primarily due to infection or occlusion. Multivariable analysis identified catheter distal tip location as the sole predictor of dysfunction OR: 0.146, 95 CI: 0.0260.816, p  0.028. Catheters with tips in the right atrium demonstrated better patency than those in the inferior vena cava. Minor complications included hematomas 11.3 and arrhythmias 16.1. Conclusions: Balloon venoplasty is a safe and effective technique for managing patients with exhausted central venous access, providing emergency hemodialysis, and acting as a bridge to definitive solutions such as AV fistulas, peritoneal dialysis, or renal transplantation. To optimize patency and reduce the risk of dysfunction, catheter tips are recommended to be placed in the right atrium. Further research is needed to refine this approach and extend access longevity.

Makale detayları

Emergent Hemodialysis Access: Balloon Venoplasty and Tunneled Catheter Placement in Patients with Exhausted Venous Access – Evaluation of Safety and Patency Determinants

Yazarlar:

Mustafa Mazıcan | İsmail Karluka

Yayıncı:

Sakarya University

Ana Başlıklar:

Radyoloji ve Organ Görüntüleme

Dergi:

Sakarya Tıp Dergisi Vol.15 Issue 3, pp.288-298

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001358012

pISSN:

2146-409X

Central venous occlusion

Balloon venoplasty

Tunneled dialysis catheter

Emergency hemodialysis

Vascular access

Central vein recanalization

Sayı

Makale detayları

Emergent Hemodialysis Access: Balloon Venoplasty and Tunneled Catheter Placement in Patients with Exhausted Venous Access – Evaluation of Safety and Patency Determinants

Yazarlar: Mustafa Mazıcan | İsmail Karluka

Yayıncı: Sakarya University

Ana Başlıklar: Radyoloji ve Organ Görüntüleme

Dergi: Sakarya Tıp Dergisi Vol.15 Issue 3, pp.288-298

Belge Tipi: Makale

Yayın Tarihi: 9/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001358012

pISSN: 2146-409X

Central venous occlusion

Balloon venoplasty

Tunneled dialysis catheter

Emergency hemodialysis

Vascular access

Central vein recanalization

Sayı

Yazarlar:

Mustafa Mazıcan | İsmail Karluka

Yayıncı:

Sakarya University

Ana Başlıklar:

Radyoloji ve Organ Görüntüleme

Dergi:

Sakarya Tıp Dergisi Vol.15 Issue 3, pp.288-298

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001358012

pISSN:

2146-409X