To explore the feasibility and safety of Guidewire-Balloon Entrapment Technique (GBET) for the recanalization of thoracic central vein occlusions (TCVOs) in hemodialysis patients.
Methods:
A retrospective observational study was conducted using data from 28 patients who required the establishment or maintenance of hemodialysis access and were treated with GBET for the recanalization of right-sided TCVOs from January 2017 to April 2021. Of the patients, 27 required tunneled cuffed catheter (TCC) placement or exchange, and 1 had an outflow tract occlusion of the Brescia-Cimino radio cephalic arteriovenous fistula (AVF).
Results:
A total of 26 patients successfully underwent TCC exchange and placement using GBET; 1 patient underwent successful recanalization of an occlusion of the outflow tract of the right Brescia-Cimino AVF; and 1 patient underwent successful TCC placement in the left internal jugular vein (LIJV) after the failure of TCC placement in the right internal jugular vein (RIJV). The success rate for GBET was 27/28 (96.43%), and there were no major complications.
Conclusion:
GBET is a safe and effective method for the recanalization of right-sided TCVOs, especially for TCC exchange and placement, and can be used as a safe and easy approach for TCVO recanalization.
SaranRRobinsonBAbbottKC, et al. US Renal data system 2018 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis2019; 73(3Suppl 1): A7–A8.
2.
ZhouSJiangHZhangP, et al. A single-center study of the application of initial hemodialysis vascular access in patients with end-stage renal disease (ESRD). Chin J Nephrol2014; 30(12): 897–902.
3.
KramerAPippiasMNoordzijM, et al. The European renal association-European dialysis and transplant association (ERA-EDTA) registry annual report 2015: a summary. Clin Kidney J2018; 11(1): 108–122.
4.
LeeT. Fistula first initiative: historical impact on vascular access practice patterns and influence on future vascular access care. Cardiovasc Eng Technol2017; 8(3): 244–254.
5.
LokCEHuberTSLeeT, et al. KDOQI vascular access guideline work group. KDOQI clinical practice guideline for vascular access: 2019 update. Am J Kidney Dis2020; 75(4): S1–S164.
6.
Working Group on Vascular Access, Hemodialysis Center Branch, China Hospital Association. Expert consensus on vascular access for hemodialysis in China (2nd ed.). Chin J Blood Purifi2019; 18(6): 365–381.
7.
AgarwalAKKhabiriHHaddadNJ. Complications of vascular access: superior vena cava syndrome. Am J Kidney Dis2019; 69(2): 309–313.
8.
DolmatchBLGurleyJCBaskinKM, et al. Central vein work group; technology assessment committee. Society of Interventional Radiology. Reporting Standards for Thoracic Central Vein Obstruction: Endorsed by the American Society of Diagnostic and Interventional Nephrology (ASDIN), British Society of Interventional Radiology (BSIR), Canadian Interventional Radiology Association (CIRA), Heart Rhythm Society (HRS), Indian Society of Vascular and Interventional Radiology (ISVIR), Vascular Access Society of the Americas (VASA), and Vascular Access Society of Britain and Ireland (VASBI). J Vasc Interv Radiol2018; 29(4): 454–460.e3.
9.
VedanthamSGrassiCJFerralH, et al. Technology assessment committe of the society of interventional radiology: reporting standards for endovascular treatment of lower extremity deep vein thrombosis. J VascInterv Radiol2006; 17(3): 417–434.
10.
CriadoEMarstonWAJaquesPF, et al. Proximal venous outflow obstruction in patients with upper extremity arteriovenous dialysis access. Ann Vasc Surg1994; 8(6): 530–535.
11.
AsifAAgarwalAKYevzlinAS, et al. Interventional nephrology. New York, NY: The McGraw-Hill Companies, Inc2012, p.207.
12.
FarrellTLangEVBarnhartW. Sharp recanalization of central venous occlusions. J Vasc Interv Radiol1999; 10(2 Pt. 1): 149–154.
13.
ArabiMAhmedIMat'hamiA, et al. Sharp central venous recanalization in hemodialysis patients: a single-institution experience. Cardiovasc Intervent Radiol2016; 39(6): 927–934.
14.
HonnefDWingenMGüntherRW, et al. Sharp central venous recanalization by means of a TIPS needle. Cardiovasc Intervent Radiol2005; 28(5): 673–676.
15.
LiuXYuYXiongN, et al. Clinical value of a sharp recanalization technique in hemodialysis related central venous obstructive diseases. Chin J Nephrology2019, 35(3): 221–223.
16.
ElayiCSAllenCLLeungS, et al. Inside-out access: a new method of lead placement for patients with central venous occlusions. Heart Rhythm2011; 8(6): 851–857.
17.
AnilGTanejaM. Revascularization of an occluded brachiocephalic vein using Outback-LTD re-entry catheter. J Vasc Surg2010; 52(4): 1038–1040.
18.
KellerEJGuptaSABondarevS, et al. Single-center retrospective review of radiofrequency wire recanalization of refractory central venous occlusions. J Vasc Interv Radiol2018; 29(11): 1571–1577.
19.
SivananthanGMacArthurDHDalyKP, et al. Safety and efficacy of radiofrequency wire recanalization of chronic central venous occlusions. J Vasc Access2015; 16(4): 309–314.
20.
GuimaraesMSchonholzCHanneganC, et al. Radiofrequency wire for the recanalization of central vein occlusions that have failed conventional endovascular techniques. J Vasc Interv Radiol2012; 23(8): 1016–1021.
21.
AyeTPhanTTMuirDF, et al. Novel experience of laser-assisted 'inside-out' central venous access in a patient with bilateral subclavian vein occlusion requiring pacemaker implantation. Europace2017; 19(10): 1750–1753.
22.
RambhiaSJankoMHackerRI. Laser recanalization of central venous occlusion to salvage a threatened arteriovenous fistula. Ann Vasc Surg2018; 50: 297.e1–297.e3.
23.
HadziomerovicAHirjiZCoffeyN. Modified inside-out technique for continued use of chronically occluded upper central veins. J Vasc Interv Radiol2017; 28(5): 757–761.
24.
Reindl-SchwaighoferRMatoussevitchVWinnickiW, et al. A novel inside-out access approach for hemodialysis catheter placement in patients with thoracic central venous occlusion. Am J Kidney Dis2020; 75(4): 480–487.
25.
VachharajaniTJKirkseyLMcLennanG. Endovascular bypass for thoracic vein occlusion: an innovative technique for hemodialysis vascular access. Am J Kidney Dis2020; 75(4): 468–470.
26.
McDevittJLSrinivasaRNGemmeteJJ, et al. Approach, technical success, complications, and stent patency of sharp recanalization for the treatment of chronic venous occlusive disease: experience in 123 patients. Cardiovasc Intervent Radiol2019; 42(2): 205–212.
27.
GuptaHMurphyTPSoaresGM. Use of a puncture needle for recanalization of an occluded right subclavian vein. Cardiovasc Intervent Radiol1998; 21(6): 508–511.
