Tunneled hemodialysis (HD) catheter-associated right atrial thrombus (CRAT) is an uncommon complication with significant morbidity. We report the case of a patient undergoing HD through tunneled venous catheter who presented with catheter dysfunction and sepsis and was diagnosed to have CRAT with septic embolism. CRAT formation has a significant association with catheter-related infection. The need for early diagnosis and various treatment options for this entity are highlighted.
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http://dx.doi.org/10.4103/ijn.IJN_125_17 | DOI Listing |
Indian J Nephrol
July 2024
Department of Medicine, INHS Asvini, Mumbai, India.
Background: External jugular vein (EJV) is used to insert tunneled dialysis catheter (TDC) in patients with no AVF and exhausted right internal jugular veins (IJV). There is scarce data on TDC insertion in EJV by nephrologists with fluoroscopy guidance.
Materials And Methods: This was a prospective observational study that included hemodialysis patients with exhausted right IJV access who underwent EJV TDC insertion, and excluded occluded ipsilateral brachiocephalic vein or superior vena cava, EJV < 5 mm diameter, or patients with existing EJV TDC.
J Vasc Access
January 2025
Division of Nephrology, West China Hospital of Medicine, Chengdu, Sichuan, China.
This case report describes a surgical treatment combined with interventional therapy for a patient with refractory hemodialysis access combined with catheter-related right atrial thrombosis (CRAT). During surgery, an artificial graft was established from the left brachiocephalic vein to the right atrium and the right atrial thrombus was removed. After the operation, the tunneled cuffed catheter (TCC) was replaced with digital subtraction angiography (DSA).
View Article and Find Full Text PDFJ Vasc Access
January 2025
Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia.
Introduction: In many countries, hemodialysis is still the most common method of renal replacement. Significant regional variations exist in creating and maintaining vascular access for hemodialysis. Therefore, analyzing national registries with vascular access data is essential for developing effective national treatment strategies.
View Article and Find Full Text PDFBackground And Aims: A catheter-related bloodstream infection (CRBSI) is a life-threatening complication of hemodialysis. It is responsible for significant morbidity and mortality and a costly long hospital stay. Despite its burden, little is known about the factors associated with it and the antibiogram of its responsible causative bacteria.
View Article and Find Full Text PDFKidney Med
January 2025
Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Expansion of home hemodialysis (HHD) provides an opportunity to improve clinical outcomes, reduce cost of care, and address the staffing challenges currently faced in caring for patients with kidney failure on replacement therapy. To increase HHD expansion, current practices and barriers to home dialysis must be examined and addressed. One such barrier is vascular access for HHD; although tunneled hemodialysis central venous catheters (CVCs) have been used for decades, physicians still hesitate to send patients home without a mature, functional arteriovenous access.
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