Percutaneous endovascular salvage techniques for implanted venous access device dysfunction.

Détails

ID Serval
serval:BIB_06AA705D6596
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Percutaneous endovascular salvage techniques for implanted venous access device dysfunction.
Périodique
Cardiovascular and interventional radiology
Auteur(s)
Breault S., Glauser F., Babaker M., Doenz F., Qanadli S.D.
ISSN
1432-086X (Electronic)
ISSN-L
0174-1551
Statut éditorial
Publié
Date de publication
06/2015
Peer-reviewed
Oui
Volume
38
Numéro
3
Pages
642-650
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Implanted venous access devices (IVADs) are often used in patients who require long-term intravenous drug administration. The most common causes of device dysfunction include occlusion by fibrin sheath and/or catheter adherence to the vessel wall. We present percutaneous endovascular salvage techniques to restore function in occluded catheters. The aim of this study was to evaluate the feasibility, safety, and efficacy of these techniques.
Through a femoral or brachial venous access, a snare is used to remove fibrin sheath around the IVAD catheter tip. If device dysfunction is caused by catheter adherences to the vessel wall, a new "mechanical adhesiolysis" maneuver was performed. IVAD salvage procedures performed between 2005 and 2013 were analyzed. Data included clinical background, catheter tip position, success rate, recurrence, and rate of complication.
Eighty-eight salvage procedures were performed in 80 patients, mostly women (52.5 %), with a mean age of 54 years. Only a minority (17.5 %) of evaluated catheters were located at an optimal position (i.e., cavoatrial junction ±1 cm). Mechanical adhesiolysis or other additional maneuvers were used in 21 cases (24 %). Overall technical success rate was 93.2 %. Malposition and/or vessel wall adherences were the main cause of technical failure. No complications were noted.
These IVAD salvage techniques are safe and efficient. When a catheter is adherent to the vessel wall, mechanical adhesiolysis maneuvers allow catheter mobilization and a greater success rate with no additional risk. In patients who still require long-term use of their IVAD, these procedures can be performed safely to avoid catheter replacement.

Mots-clé
Adolescent, Adult, Aged, Aged, 80 and over, Catheterization, Central Venous/instrumentation, Catheters, Indwelling, Endovascular Procedures/instrumentation, Endovascular Procedures/methods, Equipment Failure, Feasibility Studies, Female, Fibrin, Humans, Male, Middle Aged, Treatment Outcome, Young Adult
Pubmed
Création de la notice
10/12/2014 11:28
Dernière modification de la notice
20/08/2019 13:28
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