Placement of hemodialysis catheters with the help of the micropuncture technique in patients with central venous occlusion and limited access

This study aims to describe the technical success of the micropuncture technique, which is performed in placement of tunneled hemodialysis catheters in patients with central venous occlusion and limited access. A total of 25 patients with central venous occlusion and in need of catheter placement for hemodialysis between 2012 and 2018 were included in this study and analyzed retrospectively. Technical success was defined as the placement of tunneled dialysis catheters with optimal position and function. Internal jugular vein access in 16 patients (14 right and 2 left) and right subclavian vein access in 3 patients were successfully performed in placement of the tunneled dialysis catheter. Although internal jugular and subclavian vein access was attempted bilater- ally, the procedure failed in 6 patients. The overall technical success of recanalization of the occluded central veins was 76% (19/25). No minor or major complications were encountered. Tunneled dialysis catheter placement through the occluded internal jugular and subclavian veins with the micropuncture technique is effective and safe in patients with limited vascular access. The recanalization of the occluded conventional access routes should always be kept in mind to allow for the preservation of vascular accesses for future requirements.