Disfonksiyone tünelli hemodiyaliz kateterlerinin değişiminde balon anjiyoplasti uygulamasının kateter patensisi üzerine etkisi

Year 2019, , 167 - 173, 01.06.2019

Azad Hekimoğlu , İsmail Kırbaş Onur Ergun

https://doi.org/10.21601/ortadogutipdergisi.420973

Abstract

Amaç: Disfonksiyone tünelli hemodiyaliz kateterlerinde
en sık karşılaşılan sorun fibrin kılıf oluşumudur. Bu durumda kateter patensisini
uzatmak amacıyla farklı yöntemler mevcuttur. Bu çalışmada disfonksiyone tünelli
hemodiyaliz kataterlerinin balon anjioplasti uygulanarak değişimi ile balon anjioplasti
uygulanmadan değişiminin kateter patensisi açısından karşılaştırılması amaçlandı.

Gereç ve Yöntem: Çalışmaya disfonksiyone tünelli hemodiyaliz
kateteri bulunan 84 hastada yapılan toplam 93 kateter değişim işlemi dahil edildi.
Balon anjiyoplasti uygulanarak yapılan 52 kateter değişim işlemi ve balon anjiyoplasti
uygulanmadan yapılan 41 kateter değişim işlemi retrospektif olarak değerlendirildi.
Her iki grupta değiştirilen kateterlerin 1., 3., 6. ve 12. ayda patensilerine bakıldı.

Bulgular: Gruplar arasında yaş, cinsiyet ve kateter
lokalizasyonu açısından anlamlı farklılık saptanmadı. Değişimi yapılan tüm tünelli
kateterler için ortalama patensi süresi 5,9 ay (1 hafta-29 ay) olarak hesaplandı.
Balon anjioplasti uygulanan grupta kateterlerin patensi süresi ortalama 5 ay, balon
anjioplasti uygulanmayan grupta ise 7,1 ay olarak hesaplandı (p=0,083). İki grubun
patensi süreleri karşılaştırıldığında istatistiksel olarak anlamlı fark saptanmadı.

Sonuç: Disfonksiyone tünelli kateterlerde balon anjiyoplasti uygulanarak
yapılan kateter değişimi ile balon anjiyoplasi uygulanmadan yapılan kateter değişiminin
kateter patensisi açısından birbirine üstünlüğü saptanmamıştır. Bu gibi hallerde
hastanın durumu göz önünde bulundurulup, zararı ve maliyeti daha düşük işlemin seçilmesi
daha doğru yaklaşım olacaktır.

Keywords

Tünelli hemodiyaliz kateteri, fibrin kılıf, balon anjioplasti

Effect of balloon angioplasty on catheter patency in the replacement of dysfunctional tunneled hemodialysis catheters

Abstract

Aim: Fibrin sheath formation is the most common
problem in dysfunctional tunneled hemodialysis catheters. Different methods are
available to prolong catheter patency in such situations. In this study, it was
aimed to compare the effect of balloon angioplasty on catheter patency in the replacement
of dysfunctional tunneled hemodialysis catheters.

Material and Method: A total of 93 catheter exchange procedures
in 84 patients with dysfunctional tunneled hemodialysis catheters were included
in the study. Fifty-two catheter exchange procedures performed with balloon angioplasty
and 41 catheter exchange procedures performed without balloon angioplasty were retrospectively
evaluated. Catheter patency in both groups were assessed at 1st, 3rd, 6th and 12th
months.

Results: There was no significant difference in age,
sex and catheter location between the groups. The mean patency time was 5.9 months
(1 week-29 months) for all exchanged tunneled catheters. The mean patency duration
of the catheters was calculated as 5 months in the balloon angioplasty group and
7.1 months in the group without balloon angioplasty (p=0.083). There was no statistically
significant difference in patency duration of two groups.

Conclusion: Comparing patency durations of exchanged dysfunctional tunneled catheters, there was no effect of
performing balloon angioplasty during the exchange procedure. In such cases, it
would be more appropriate to consider the condition of the patient and to choose
a less harmful and costly procedure for the patient.

Keywords

Tunneled hemodialysis catheters, fibrin sheath, balloon angioplasty

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