A novel technique for tethered dialysis catheter removal using the laser sheath

Roger Carrillo, Juan D. Garisto, Loay Salman, Donna Merrill, Arif Asif

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Traction and cutdown techniques can successfully remove a tunneled dialysis catheter (TDC) in a great majority of patients. However, these methods may not be successful in patients with catheters that are tethered or attached to the central veins or the atrium. A forceful application of traction can lead to catheter breakage with subsequent retention of the broken piece and carries a potential risk of vascular and atrial wall avulsion. Open thoracotomy has been employed to remove an attached TDC. However, this procedure is invasive and bears a significant morbidity. This report presents three cases of tethered TDCs that underwent laser sheath extraction. The TDCs had been in place for an average of 26 months. The patients underwent initial unsuccessful removal attempt using the traction method with surgical exploration all the way to the venotomy site. The laser technique that is used to remove pacemaker/implantable cardioverter defibrillator leads was then applied to these stuck catheters. All three catheters were successfully removed without any damage to the catheter, central veins, or the right atrium. There were no retained catheter fragments left in the central veins or the atrium. One patient demonstrated a significant thrombus that extended from the tip of the catheter all the way to the right ventricle. The external sheath of the laser device successfully aspirated the thrombus. There were no procedure-related complications. In this small series, a laser sheath successfully extracted tethered dialysis catheters. The study found the procedure to be effective, easy to perform, and minimally invasive. We suggest that this approach be considered for the removal of tethered catheters that cannot be removed using traditional approaches.

Original languageEnglish
Pages (from-to)688-691
Number of pages4
JournalSeminars in Dialysis
Volume22
Issue number6
DOIs
StatePublished - Nov 1 2009

Fingerprint

Dialysis
Lasers
Catheters
Traction
Veins
Thrombosis
Implantable Defibrillators
Thoracotomy
Heart Atria
Heart Ventricles
Blood Vessels
Morbidity
Equipment and Supplies

ASJC Scopus subject areas

  • Nephrology

Cite this

A novel technique for tethered dialysis catheter removal using the laser sheath. / Carrillo, Roger; Garisto, Juan D.; Salman, Loay; Merrill, Donna; Asif, Arif.

In: Seminars in Dialysis, Vol. 22, No. 6, 01.11.2009, p. 688-691.

Research output: Contribution to journalArticle

Carrillo, R, Garisto, JD, Salman, L, Merrill, D & Asif, A 2009, 'A novel technique for tethered dialysis catheter removal using the laser sheath', Seminars in Dialysis, vol. 22, no. 6, pp. 688-691. https://doi.org/10.1111/j.1525-139X.2009.00646.x
Carrillo, Roger ; Garisto, Juan D. ; Salman, Loay ; Merrill, Donna ; Asif, Arif. / A novel technique for tethered dialysis catheter removal using the laser sheath. In: Seminars in Dialysis. 2009 ; Vol. 22, No. 6. pp. 688-691.
@article{14b485b302414730b999d7892779bcfa,
title = "A novel technique for tethered dialysis catheter removal using the laser sheath",
abstract = "Traction and cutdown techniques can successfully remove a tunneled dialysis catheter (TDC) in a great majority of patients. However, these methods may not be successful in patients with catheters that are tethered or attached to the central veins or the atrium. A forceful application of traction can lead to catheter breakage with subsequent retention of the broken piece and carries a potential risk of vascular and atrial wall avulsion. Open thoracotomy has been employed to remove an attached TDC. However, this procedure is invasive and bears a significant morbidity. This report presents three cases of tethered TDCs that underwent laser sheath extraction. The TDCs had been in place for an average of 26 months. The patients underwent initial unsuccessful removal attempt using the traction method with surgical exploration all the way to the venotomy site. The laser technique that is used to remove pacemaker/implantable cardioverter defibrillator leads was then applied to these stuck catheters. All three catheters were successfully removed without any damage to the catheter, central veins, or the right atrium. There were no retained catheter fragments left in the central veins or the atrium. One patient demonstrated a significant thrombus that extended from the tip of the catheter all the way to the right ventricle. The external sheath of the laser device successfully aspirated the thrombus. There were no procedure-related complications. In this small series, a laser sheath successfully extracted tethered dialysis catheters. The study found the procedure to be effective, easy to perform, and minimally invasive. We suggest that this approach be considered for the removal of tethered catheters that cannot be removed using traditional approaches.",
author = "Roger Carrillo and Garisto, {Juan D.} and Loay Salman and Donna Merrill and Arif Asif",
year = "2009",
month = "11",
day = "1",
doi = "10.1111/j.1525-139X.2009.00646.x",
language = "English",
volume = "22",
pages = "688--691",
journal = "Seminars in Dialysis",
issn = "0894-0959",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - A novel technique for tethered dialysis catheter removal using the laser sheath

AU - Carrillo, Roger

AU - Garisto, Juan D.

AU - Salman, Loay

AU - Merrill, Donna

AU - Asif, Arif

PY - 2009/11/1

Y1 - 2009/11/1

N2 - Traction and cutdown techniques can successfully remove a tunneled dialysis catheter (TDC) in a great majority of patients. However, these methods may not be successful in patients with catheters that are tethered or attached to the central veins or the atrium. A forceful application of traction can lead to catheter breakage with subsequent retention of the broken piece and carries a potential risk of vascular and atrial wall avulsion. Open thoracotomy has been employed to remove an attached TDC. However, this procedure is invasive and bears a significant morbidity. This report presents three cases of tethered TDCs that underwent laser sheath extraction. The TDCs had been in place for an average of 26 months. The patients underwent initial unsuccessful removal attempt using the traction method with surgical exploration all the way to the venotomy site. The laser technique that is used to remove pacemaker/implantable cardioverter defibrillator leads was then applied to these stuck catheters. All three catheters were successfully removed without any damage to the catheter, central veins, or the right atrium. There were no retained catheter fragments left in the central veins or the atrium. One patient demonstrated a significant thrombus that extended from the tip of the catheter all the way to the right ventricle. The external sheath of the laser device successfully aspirated the thrombus. There were no procedure-related complications. In this small series, a laser sheath successfully extracted tethered dialysis catheters. The study found the procedure to be effective, easy to perform, and minimally invasive. We suggest that this approach be considered for the removal of tethered catheters that cannot be removed using traditional approaches.

AB - Traction and cutdown techniques can successfully remove a tunneled dialysis catheter (TDC) in a great majority of patients. However, these methods may not be successful in patients with catheters that are tethered or attached to the central veins or the atrium. A forceful application of traction can lead to catheter breakage with subsequent retention of the broken piece and carries a potential risk of vascular and atrial wall avulsion. Open thoracotomy has been employed to remove an attached TDC. However, this procedure is invasive and bears a significant morbidity. This report presents three cases of tethered TDCs that underwent laser sheath extraction. The TDCs had been in place for an average of 26 months. The patients underwent initial unsuccessful removal attempt using the traction method with surgical exploration all the way to the venotomy site. The laser technique that is used to remove pacemaker/implantable cardioverter defibrillator leads was then applied to these stuck catheters. All three catheters were successfully removed without any damage to the catheter, central veins, or the right atrium. There were no retained catheter fragments left in the central veins or the atrium. One patient demonstrated a significant thrombus that extended from the tip of the catheter all the way to the right ventricle. The external sheath of the laser device successfully aspirated the thrombus. There were no procedure-related complications. In this small series, a laser sheath successfully extracted tethered dialysis catheters. The study found the procedure to be effective, easy to perform, and minimally invasive. We suggest that this approach be considered for the removal of tethered catheters that cannot be removed using traditional approaches.

UR - http://www.scopus.com/inward/record.url?scp=71549158252&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=71549158252&partnerID=8YFLogxK

U2 - 10.1111/j.1525-139X.2009.00646.x

DO - 10.1111/j.1525-139X.2009.00646.x

M3 - Article

C2 - 20017840

AN - SCOPUS:71549158252

VL - 22

SP - 688

EP - 691

JO - Seminars in Dialysis

JF - Seminars in Dialysis

SN - 0894-0959

IS - 6

ER -