Abstract:

Objectives: Vascular access has prime importance in patients on hemodialysis. Tunneled dialysis catheter is one of the major types of vascular access. The most frequent tunneled hemodialysis catheter loss is due to infection and thrombosis of the catheter. Vascular access loss can be caused by accidental dislodgement of the catheter. The aim of this study was to evaluate the success rate of re-insertion of accidentally lost tunneled venous catheters using existing subcutaneous tracts.Methods and Materials: This retrospective study included 35 patients who presented with inadvertent loss of tunneled hemodialysis catheter while on a chronic hemodialysis program. The study was conducted between 2010 and 2017. With the exception of 1 patient where the time elapsed was 3 weeks, the time from catheter dislodgement to insertion of a new catheter was a mean of 18±9 hours range, 4–72 hours . The technique of allowing new catheter insertion via the existing subcutaneous tunnel is presented in this paper.Result: The technical success of the re-insertion of tunneled HD catheters via existing subcutaneous tracks was achieved in all cases. No complications were observed during the process or follow-up period.Conclusions: It was concluded that this technique has two main advantages compared to the re-insertion of the catheter to a new site. The first is that no complications were observed in any patients when the catheter was re-inserted through the subcutaneous exit site. The second advantage is that this technique takes less time, which makes the procedure more comfortable for the patient and decreases the need for sedation

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