Crain M R, Mewissen M W, Ostrowski G J, Paz-Fumagalli R, Beres R A, Wertz R A
Department of Radiology, Medical College of Wisconsin, Milwaukee 53226, USA.
Radiology. 1996 Jan;198(1):41-4. doi: 10.1148/radiology.198.3.41a.
To evaluate percutaneous fibrin sleeve stripping (PFSS) to prolong functional patency in failing hemodialysis catheters.
Forty PFSS procedures were performed in 24 catheters in 23 consecutive patients with an inadequate blood flow rate (< 200 mL/min) during hemodialysis. The fibrin sleeve was mechanically stripped off the shaft of the catheter with a snare introduced via the common femoral vein. Durability of PFSS was determined with life-table analysis.
Median time from catheter placement to initial failure was 3.5 months (range, 5 days to 22 months). The technical success rate for PFSS was 100%; initial patency was restored in 39 of 40 procedures (98%), and no symptomatic pulmonary embolism occurred. Primary patency after single PFSS was 45% at 3 months and 28% at 6 months (median added patency, 2.8 months). Postprocedure secondary patency with multiple PFSS procedures was 83% at 3 months and 72% at 6 months (P = .01) (overall catheter patency, 90% at 6 months and 81% at 1 year [P < .001]).
Multiple PFSS procedures can prolong patency in hemodialysis catheters with a fibrin sleeve.
