Yosuke Saka1, Yasuhiko Ito2, Yoshiyasu Iida3, Shoichi Maruyama2, Seiichi Matsuo2. 1. Department of Internal Medicine, Kasugai Municipal Hospital, 1-1-1 Takakicho, Kasugai, 486-8510, Aichi, Japan. yosukesaka@hospital.kasugai.aichi.jp. 2. Department of Nephrology, Nagoya University Graduate School of Medicine, Showaku, Nagoya, Aichi, Japan. 3. Department of Nephrology, Yokkaichi Municipal Hospital, Yokkaichi, Mie, Japan.
Abstract
BACKGROUND: Catheter malposition is one of the reasons for outflow failure in peritoneal dialysis (PD) patients. Fluoroscopic manipulation is a non-surgical treatment option for catheter malposition. We retrospectively analyzed the efficacy and safety of fluoroscopic manipulation using an alpha-replacer guidewire. METHODS: The alpha-replacer (JMS Co. Ltd., Tokyo, Japan) is a guidewire for the treatment of catheter malposition. We used the alpha-replacer in 23 PD cases at our hospital from January 2008 to December 2012. We evaluated body mass index, time interval between catheter placement and malposition, and interval between catheter exteriorization and malposition. Primary failure was defined as malposition at the time of catheter exteriorization, and secondary failure as malposition after functional PD therapy (correct position at time of exteriorization). RESULTS: Successful catheter replacement rate using the alpha-replacer was 60.8 % (14 of 23 cases). This was similar to the rates in previous reports. Successful replacement was mostly observed in those with a long interval between catheter placement and malposition (p = 0.048), between catheter placement and exteriorization (p = 0.047) and with secondary failure (p = 0.030). In multivariate analysis, secondary failure cases had a higher rate of successful replacement than primary failure cases (odds ratio [OR] 7.33, p = 0.038). Serious complications, such as abdominal trauma or peritonitis, were not observed. CONCLUSION: Fluoroscopic manipulation using an alpha-replacer may be safe and effective for the management of peritoneal catheter malposition, particularly in patients who were under functional PD therapy until catheter malposition.
BACKGROUND: Catheter malposition is one of the reasons for outflow failure in peritoneal dialysis (PD) patients. Fluoroscopic manipulation is a non-surgical treatment option for catheter malposition. We retrospectively analyzed the efficacy and safety of fluoroscopic manipulation using an alpha-replacer guidewire. METHODS: The alpha-replacer (JMS Co. Ltd., Tokyo, Japan) is a guidewire for the treatment of catheter malposition. We used the alpha-replacer in 23 PD cases at our hospital from January 2008 to December 2012. We evaluated body mass index, time interval between catheter placement and malposition, and interval between catheter exteriorization and malposition. Primary failure was defined as malposition at the time of catheter exteriorization, and secondary failure as malposition after functional PD therapy (correct position at time of exteriorization). RESULTS: Successful catheter replacement rate using the alpha-replacer was 60.8 % (14 of 23 cases). This was similar to the rates in previous reports. Successful replacement was mostly observed in those with a long interval between catheter placement and malposition (p = 0.048), between catheter placement and exteriorization (p = 0.047) and with secondary failure (p = 0.030). In multivariate analysis, secondary failure cases had a higher rate of successful replacement than primary failure cases (odds ratio [OR] 7.33, p = 0.038). Serious complications, such as abdominal trauma or peritonitis, were not observed. CONCLUSION: Fluoroscopic manipulation using an alpha-replacer may be safe and effective for the management of peritoneal catheter malposition, particularly in patients who were under functional PD therapy until catheter malposition.
Authors: Ana Figueiredo; Bak-Leong Goh; Sarah Jenkins; David W Johnson; Robert Mactier; Santhanam Ramalakshmi; Badri Shrestha; Dirk Struijk; Martin Wilkie Journal: Perit Dial Int Date: 2010 Jul-Aug Impact factor: 1.756
Authors: Tatiana Tanasiychuk; Rafael Selgas; Daniel Kushnir; Muhammad Abd Elhalim; Alon Antebi; Gloria Del Peso; Maria A Bajo; Victor Frajewicki Journal: Int Urol Nephrol Date: 2019-07-01 Impact factor: 2.370