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Report on an Italian survey of 72 stuck hemodialysis catheters

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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 Among these, 47 (77%) stuck tunnelled central venous catheters were successfully removed, while 14 (23%) failed to be withdrawn.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.

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Acknowledgements

To all centres and colleagues participating in the survey. Acquaviva delle Fonti (C. Lomonte), Agrigento (A. Granata), Alba (A. Campo), Asti (N. Giotta), Borgomanero (S. Cusinato), NS di Bonaria San Gavino M.le (M, Spina), Carbonia (K. Rosas), Catania (W. Morale), Chieri (M. Salomone), Chivasso (G. Martina), Ivrea (M. Francisco), Lecce (F. Russo), Legnano (M. Cornacchiari), Modena (L. Lucchi), Palmanova (M. Tosto), Pavia (P. Quaretti), Pescara (M. Lodi), Pinerolo (A. Marciello), Rivoli (S. Ferrero), Roma Gemelli (L. Tazza), Salerno (M. Punzi), San Giovanni Rotondo (G. Gatta), San Miniato (V. Finato), Senigallia (S. Cenerelli), Torino CTO (D. Damiani), Torino G. Bosco (P. Cecere), Torino Martini (G. Cesano), Torino Mauriziano (S. Berutti), Torino Città della Salute (G. Leonardi), Verona (V. Bedogna).

Funding

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Author information

Authors and Affiliations

  1. CMID-Nephrology and Dialysis Unit (ERK-Net), Center of Research of Nephrology, Rheumatology and Rare Disease, Coordinating Center of the Network of Rare Disease of Piedmont and Aosta Valley, G. Bosco Hospital and University of Turin, Piazza del Donatore di Sangue 3, 10154, Turin, Italy

    Giacomo Forneris, Pasqualina Cecere, Marco Pozzato & Dario Roccatello

  2. Interventional Radiology Unit, Radiology Department, G. Bosco Hospital, Turin, Italy

    Daniele Savio & Luca Di Maggio

  3. Interventional Radiology Unit, Radiology Department, IRCCS Policlinico San Matteo, Pavia, Italy

    Pietro Quaretti

  4. Nephrology and Dialysis, Spirito Santo Hospital, Pescara, Italy

    Massimo Lodi

  5. Division of Neuroradiology and Interventional Radiology, AO Brotzu, Cagliari, Italy

    Simone Comelli

  6. Nephrology and Dialysis, A.O. Cannizzaro, Catania, Italy

    Walter Morale

  7. Nephrology and Dialysis, NS di Bonaria, San Gavino Monreale, VS, Italy

    Monica Spina

  8. Nephrology Unit, Asst Ovest Milanese-Magenta Hospital, Milan, Italy

    Marina Cornacchiari

  9. Vascular Access Service for Hemodialysis, Nephrocare, Rome, Italy

    Massimo Punzi

  10. Department of Nephrology and Dialysis, Scientific Institute for Research and Health Care “Casa Sollievo della Sofferenza” IRCCS, San Giovanni Rotondo, Italy

    Giuseppe Gatta

  11. Division of Nephrology and Dialysis, ASL TO3 di Collegno Pinerolo, PO “Edoardo Agnelli”, Pinerolo, Italy

    Antonio Marciello

Authors
  1. Giacomo Forneris
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  2. Daniele Savio
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  3. Pietro Quaretti
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  4. Massimo Lodi
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  5. Simone Comelli
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  6. Walter Morale
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  7. Monica Spina
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  8. Luca Di Maggio
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  9. Marina Cornacchiari
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  10. Massimo Punzi
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  11. Giuseppe Gatta
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  12. Pasqualina Cecere
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  13. Marco Pozzato
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  14. Antonio Marciello
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  15. Dario Roccatello
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Consortia

the Vascular Access Study Project Group of the Italian Society of Nephrology

  • Giacomo Forneris
  •  & Antonio Marciello

Contributions

Survey project, material preparation, data collection and analysis were performed by GF, DS and AM. The first draft of the manuscript was written by Giacomo Forneris and reviewed by DR. All authors commented on the previous version; all authors sent cases, read and contributed to the discussion of results and approved the final manuscript.

Corresponding author

Correspondence to Giacomo Forneris.

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Conflict of interest

The authors disclose all relationship or interest that could have direct or potential influence or impart bias in the work.

Research involving human participating and/or animals

This study was conducted in accordance with Good Clinical Practice Guidelines and the Declaration of Helsinki.

Informed consent

Informed consent was obtained where possible retrospectively and all data acquired anonymously. The study describes data collected on a procedure with no currently available alternatives and regulated by a dedicated specific integrated care pathways protocol of the Piedmont Region (North West Italy).

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Forneris, G., Savio, D., Quaretti, P. et al. Report on an Italian survey of 72 stuck hemodialysis catheters. J Nephrol 36, 359–365 (2023). https://doi.org/10.1007/s40620-022-01474-y

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  • DOI: https://doi.org/10.1007/s40620-022-01474-y

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