Korean J Nephrol.  2004 Jul;23(4):676-680.

A Case of Tunneled Cuffed Catheter Dysfunction Treated with Fibrin Sheath Stripping

• Jung CS
• Nam DI
• Park DY
• Kim DS
• Choi CH
• Lee YK
• Kim SG
• Oh KH
• Yoon JW
• Koo JR
• Noh JW
• Shin SJ

Abstract

With the increasing proportion of elderly and diabetic dialysis patients, permanent dual lumen catheters are becoming popular. One of the most frequent causes for the failure of hemodialysis in CRF patients with the tunneled cuffed catheter is the catheter dysfunction. It is thought to be due to encasement of the catheter by fibrin sleeve or fibrin sheath, kinking or malposition of the catheter. Catheter dysfunction due to fibrin sheath formation could sometimes be managed by reversal of arterial and venous lines, urokinase lock or infusion, and catheter exchange. Recently percutaneous fibrin sheath stripping (PFSS) became another modality of salvaging failing tunneled cuffed catheter before attempting catheter exchange. There was no report of applying PFSS to salvage the permanent dual lumen catheter in Korea. Authors recently experienced a case of successful application of PFSS to extend the life of catheter in a CRF patients as a last resort after failure of repeated urokinase trials. It is thought that PFSS is a simple and effective procedure which extends the longevity of permanent dual lumen catheter.

Keyword

Fibrin sheath stripping; Catheter dysfunction; Tunneled cuffed catheter

MeSH Terms

Aged
Catheters*
Dialysis
Fibrin*
Health Resorts
Humans
Korea
Longevity
Renal Dialysis
Urokinase-Type Plasminogen Activator
Fibrin
Urokinase-Type Plasminogen Activator