Application of an Alternative Technique for Tunneled Hemodialysis Catheter Replacement

Zapata Salazar Homero Diego, Reyna Sepúlveda Francisco Javier, Muñoz Maldonado Gerardo Enrique, Hernández Guedea Marco Antonio, Pérez Rodríguez Edelmiro and Zapata Chavira Homero Arturo

General Surgery Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, México

^*Correspondance to: Homero Arturo Zapata Chavira 

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Abstract:

Objective: To evaluate the safety and efficacy of two novel surgical techniques for the replacement of tunneled hemodialysis catheters (THCs) in patients experiencing catheter dysfunction. Materials and Methods: A prospective study was conducted on 13 patients. Seven patients underwent catheter replacement by advancing a guidewire between the fibrous sheath and the catheter, while six patients underwent replacement using a puncture technique through the dysfunctional catheter. Demographic data, flow rates, and clinical follow-up information were collected. Results: Of the 13 patients, seven (53.8%) underwent catheter replacement using a hydrophilic guidewire passed between the fibrous sheath and the catheter (group 1), and six (46.2%) underwent replacement via the catheter puncture technique due to inability to advance the guidewire through the sheath (group 2). All catheters were successfully placed without complications. The average time between the initial THCs placement and replacement was 14 months. Regarding flow rates, the mean pre-exchange flow rate in group 1 was 264.3 mL/min (Std.deviation 12.72) and 317.1 mL/min (Std.deviation 14.96) post-exchange, with a statistically significant difference (p=0.0001). In group 2, the average pre-exchange flow rate was 273.3 mL/min (Std.deviation 13.66), increasing to 336.7 mL/min (Std.deviation 16.33) post-exchange with a statistically significant difference (p= 0.0002). Conclusions: In HD patients with THCs dysfunction, the described catheter replacement techniques are safe and effective, preserving venous access and avoiding complications. Larger studies are needed to confirm their efficacy.

Keywords:

Hemodialysis; Replacement; Tunneled hemodialysis catheters; Dysfunctional catheter

Cite the Article:

Homero Diego ZS, Francisco Javier RS, Gerardo Enrique MM, Marco Antonio HG, Edelmiro PR, Homero Arturo ZC. Application of an Alternative Technique for Tunneled Hemodialysis Catheter Replacement. World J Surg Surgical Res. 2025; 8: 1605..