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隧道式心房导管：尽管存在相关血栓形成，但仍是透析中血管资源耗竭的一种有前景的解决方案。

The Tunnelled Atrial Catheter: A Promising Solution for Vascular Capital Depletion in Dialysis despite Associated Thrombi.

作者信息

Hajji Meriam, Saied Salah, Mami Ikram, Khadhar Yassine, Ben Ayed Tasnim, Gorsane Imen, Ben Hamida Fethi, Ziadi Jalel, Zouaghi Mohamed Karim, Abderrahim Ezzeddine

机构信息

Department of Medicine A, Charles Nicolle Hospital, Tunis, Tunisia.

Laboratory of Kidney Pathology LR00SP01, Tunis, Tunisia.

出版信息

Case Rep Nephrol. 2024 Mar 15;2024:5219914. doi: 10.1155/2024/5219914. eCollection 2024.

DOI:10.1155/2024/5219914
PMID:38525052
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10959585/
Abstract

INTRODUCTION

Longer survival in dialysis led to a higher incidence of vascular access complications and failure. With the limited access to kidney transplantation programs and peritoneal dialysis, exhaustion of vascular access for hemodialysis is an increasingly common situation. Among the available options, atrial tunneled dialysis catheter (ATDC) has been reported as an effective vascular access in this population. . We report the experiences of two nephrology centers in Tunis with ATDC as an ultimate vascular access for dialysis. . Two patients with exhausted vasculature underwent ATDC insertion in 2020 and 2022, respectively, as a vascular access of last resort. Both patients underwent CRBI, which resolved with favorable outcomes. One case was complicated by post-operative thrombosis and was successfully treated with thrombolysis. Both patients are currently on dialysis via their ATDC with a catheter patency of 29 months.

CONCLUSION

ATDC is a life-saving and safe vascular access in cases of depleted vasculature. Little more than 50 cases have been reported in the literature during the last 30 years. As the frequency of vasculature exhaustion is expected to increase, preservation of veinous access in patients at risk of chronic kidney disease have never been more crucial.

摘要

引言

透析时间延长导致血管通路并发症和失败的发生率更高。由于肾移植项目和腹膜透析的可及性有限，血液透析血管通路耗尽的情况日益普遍。在现有选择中，心房隧道式透析导管（ATDC）已被报道为该人群有效的血管通路。我们报告了突尼斯两个肾脏病中心将ATDC作为最终透析血管通路的经验。2020年和2022年，分别有两名血管系统衰竭的患者接受了ATDC插入术，作为最后的血管通路。两名患者均发生了导管相关血流感染（CRBI），经治疗后预后良好。其中1例术后并发血栓形成，经溶栓治疗成功。两名患者目前均通过ATDC进行透析，导管通畅时间为29个月。

结论

对于血管系统耗竭的病例，ATDC是一种挽救生命且安全的血管通路。在过去30年中，文献报道的病例不超过50例。随着血管系统耗竭的频率预计会增加，对于有慢性肾脏病风险的患者，保留静脉通路从未如此关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc0/10959585/b6f6061528de/CRIN2024-5219914.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc0/10959585/801ad4b94618/CRIN2024-5219914.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc0/10959585/0ca579308ff8/CRIN2024-5219914.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc0/10959585/1c9c9e43fea4/CRIN2024-5219914.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc0/10959585/b6f6061528de/CRIN2024-5219914.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc0/10959585/801ad4b94618/CRIN2024-5219914.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc0/10959585/0ca579308ff8/CRIN2024-5219914.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc0/10959585/1c9c9e43fea4/CRIN2024-5219914.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc0/10959585/b6f6061528de/CRIN2024-5219914.004.jpg

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