Balloon angioplasty for disruption of tunneled dialysis catheter fibrin sheath.

PURPOSE: Management of failing tunneled hemodialysis catheters, sometimes the only vascular access for hemodialysis, presents a difficult problem. In spite of various techniques having been developed, no consensus has been reached about the preferred technique, associated with the longest catheter patency.
METHODS: We report disruption of the fibrin sheath covering dysfunctional tunneled hemodialysis catheter by means of angioplasty, followed by over guidewire catheter exchange.
RESULTS: Following the procedure, the catheter placed in the recovered lumen of the vessel presented correct function.
CONCLUSIONS: The described procedure allowed maintenance of vascular access in our patient. Additionally, dilatation of the concomitant central vein stenosis opens an option for another attempt for arteriovenous fistula creation.