Examination of Cuffed Catheter Tip Thrombosis in Hemodialysis Patients

Abstract

Background and Objective: The use of cuffed catheters for hemodialysis in patients with chronic kidney failure has increased. Thrombosis of cuffed catheter tip is a dangerous complication that can lead to catheter dysfunction and even threaten the patient's life. This study was conducted with the aim of determining the prevalence and causes of cuffed catheter tip thrombosis in order to maintain its function. Methods: This cross-sectional study was conducted in 2020 on patients with chronic kidney failure in Babol who were referred by a nephrologist due to dysfunction of the cuffed catheter. After recording demographic information, all patients were candidates for echocardiography and then venography through the catheter in the angiography unit to determine the cause of cuffed catheter dysfunction. The presence of thrombosis in the catheter tip, the formation of fibrin sheath and the location of the catheter tip were investigated. Findings: 91 patients, including 54 men (59.3%) and 37 women (40.7%) were included in the study due to lack of effective dialysis caused by cuffed catheter dysfunction. The average age of the patients was 62.01±14.66 years with a minimum age of 29 and a maximum of 88 years. The most common location of catheter placement was the right internal jugular vein in 79 cases (86.8%). The incidence rate of thrombosis in cuffed catheter tips was 53 cases (59%), with inappropriate location of the catheter tip in 31 cases (58.49%) as the most common cause, while formation of fibrin sheath in the catheter tip in 12 patients (22.64%) and inappropriate catheter length in 10 patients (18.86%) were respectively the other common causes of thrombosis in the tips of cuffed catheters. Conclusion: The results of the study showed that inappropriate location of the catheter tip was the most common cause of thrombosis in cuffed catheter tips. Therefore, it is recommended to use fluoroscopy during cuffed catheter insertion to ensure the correct placement of the catheter tip inside the right atrium.

Keywords

• central venous catheter
• thrombosis
• catheter obstruction.