Conversion to a permanent vascular catheter from a temporary vascular catheter using a guidewire

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  • Okihara Masaaki
    Department of Kidney Transplantation Surgery, Tokyo Medical University Hachioji Medical Center
  • Hoshino Takahiko
    Department of Nephrology, Tokyo Medical University Hachioji Medical Center
  • Mukae Mitsuya
    Department of Nephrology, Tokyo Medical University Hachioji Medical Center
  • Sakai Takashi
    Department of Nephrology, Tokyo Medical University Hachioji Medical Center
  • Kojima Aki
    Department of Nephrology, Tokyo Medical University Hachioji Medical Center
  • Matsuzaki Tomoko
    Department of Nephrology, Tokyo Medical University Hachioji Medical Center
  • Akashi Isao
    Department of Kidney Transplantation Surgery, Tokyo Medical University Hachioji Medical Center
  • Kihara Yu
    Department of Kidney Transplantation Surgery, Tokyo Medical University Hachioji Medical Center
  • Konno Osamu
    Department of Kidney Transplantation Surgery, Tokyo Medical University Hachioji Medical Center
  • Oda Takashi
    Department of Nephrology, Tokyo Medical University Hachioji Medical Center
  • Iwamoto Hitoshi
    Department of Kidney Transplantation Surgery, Tokyo Medical University Hachioji Medical Center

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Other Title
  • 短期型バスキュラーカテーテル留置患者に対するガイドワイヤーを用いた長期型バスキュラーカテーテルへの入れ替え手技の検討
  • タンキガタ バスキュラーカテーテル リュウチ カンジャ ニ タイスル ガイドワイヤー オ モチイタ チョウキガタ バスキュラーカテーテル エ ノ イレカエ シュギ ノ ケントウ

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<p>Recently, the number of patients requiring vascular access points involving a permanent vascular catheter (PVC) (particularly dialysis patients in whom creating an arteriovenous fistula would be difficult, e.g., because of cardiovascular dysfunction and/or long‒term bed rest) or a temporary vascular catheter (TVC) (e.g., patients who require incident dialysis or have occluded vascular access points) has increased. Central venous catheterization can cause various complications, such as artery puncture, hematoma formation, and pneumothorax. In the present study, we investigated the validity and safety of a surgical technique for the orthotopic exchange of a TVC for a PVC using a guidewire, with the aim of reducing the risk of complications of PVC insertion. We reviewed the cases of 87 patients who underwent PVC insertion at our center between April 2017 and April 2020. We compared the results of 27 patients who underwent orthotopic TVC exchange for a PVC using a guidewire with those of 60 patients who underwent catheter insertion at a new site. There were no significant differences in patient background factors between the groups. In addition, we observed no significant difference with regards to the complications rate, operating time, catheter‒related infections, or the short‒term patency rate. The patients who underwent guidewire‒based exchange reported no complications. Thus, these results suggest that the orthotopic exchange of a TVC for a PVC using a guidewire may be clinically useful.</p>

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