Fibrin sleeve stripping for salvage of failing hemodialysis catheters: technique and initial results

Radiology. 1996 Jan;198(1):41-4. doi: 10.1148/radiology.198.1.8539402.

Abstract

Purpose: To evaluate percutaneous fibrin sleeve stripping (PFSS) to prolong functional patency in failing hemodialysis catheters.

Materials and methods: 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.

Results: 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]).

Conclusion: Multiple PFSS procedures can prolong patency in hemodialysis catheters with a fibrin sleeve.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Flow Velocity
  • Catheterization, Central Venous / adverse effects
  • Catheters, Indwelling / adverse effects*
  • Female
  • Fibrin
  • Humans
  • Male
  • Middle Aged
  • Punctures
  • Radiography, Interventional / methods*
  • Renal Dialysis*

Substances

  • Fibrin