The outcome of ultrasound-guided insertion of central hemodialysis catheter

Ehab M. Abdo; Tamer A. Abouelgreed; Waleed E. Elshinawy; Nehal Farouk; Hassan Ismail; Amal H. Ibrahim; Samar A. Kasem; Lobna Kh. Sakr; Naglaa M. Aboelsoud; Nermeen M.  Abdelmonem; Salma F. Abdelkader; Ahmed A. Abdelwahed; Anas A. Qasem; Mosab F. Alassal; Ahmed A. Aboomar

doi:10.4081/aiua.2023.11588

Authors

Ehab M. Abdo Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. https://orcid.org/0000-0003-1403-452X
Tamer A. Abouelgreed
dr_tamer_ali@yahoo.com
Department of Urology, Faculty of medicine, Al-Azhar University, Cairo, Egypt. https://orcid.org/0000-0003-2640-3425
Waleed E. Elshinawy Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Nehal Farouk Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Hassan Ismail Department of Urology, Faculty of medicine, Al-Azhar University, Cairo, Egypt. https://orcid.org/0000-0002-0038-3078
Amal H. Ibrahim Department of internal medicine, Nephrology Unit, Faculty Medicine, Al-Azhar University, Cairo, Egypt. https://orcid.org/0000-0002-2786-7873
Samar A. Kasem Department of internal medicine, Nephrology Unit, Faculty Medicine, Al-Azhar University, Cairo, Egypt.
Lobna Kh. Sakr Department of Radiology, Faculty of medicine, Al-Azhar University, Cairo, Egypt.
Naglaa M. Aboelsoud Department of Radiology, Faculty of medicine, Al-Azhar University, Cairo, Egypt.
Nermeen M. Abdelmonem Department of Radiology, Thumbay University Hospital, Ajman, United Arab Emirates. https://orcid.org/0009-0008-1026-6247
Salma F. Abdelkader Department of Radiology, Faculty of Medicine Ain Shams University, Cairo, Egypt. https://orcid.org/0009-0001-1173-0872
Ahmed A. Abdelwahed Department of Radiology, Faculty of Medicine Ain Shams University, Cairo, Egypt.
Anas A. Qasem Department of Internal Medicine, Faculty Medicine, Zagazig University, Zagazig, Egypt.
Mosab F. Alassal Department of Vascular Surgery, Saudi German Hospital, Ajman, United Arab Emirates.
Ahmed A. Aboomar Department of internal medicine, Nephrology Unit, Faculty Medicine, Tanta University, Tanta, Egypt.

Objective: To point out our experience and assess the efficacy and safety of real-time ultrasound-guided central internal jugular vein (IJV) catheterization in the treatment of hemodialysis patients. Methods: This retrospective study comprised 150 patients with end-stage renal disease (ESRD) who had real-time ultrasonography (US)-guided IJV HD catheters placed in our hospital between March 2019 and March 2021. Patients were examined for their demographic data, etiology, site of catheter insertion, type (acute or chronic) of renal failure, technical success, operative time, number of needle punctures, and procedure-related complications. Patients who have had multiple catheter insertions, prior catheterization challenges, poor compliance, obesity, bony deformity, and coagulation disorders were considered at high-operative risk. Results: All patients experienced technical success. In terms of patient clinical features, an insignificant difference was observed between the normal and high-risk groups (p-value > 0.05). Of the 150 catheters, 62 (41.3%) were placed in high-risk patients. The first-attempt success rate was 89.8% for the normal group and 72.5% for the high-risk group (p = 0.006). IJV cannulation took less time in the normal-risk group compared to the highrisk group (21.2 ± 0.09) minutes vs (35.4 ± 0.11) minutes, (p < 0.001). There were no serious complications. During the placing of the catheter in the internal jugular vein, four patients (6.4%) experienced arterial puncture in the high-risk group. Two participants in each group got a small neck hematoma. One patient developed a pneumothorax in the high-risk group, which was managed with an intercostal chest tube insertion. Conclusions: Even in the high-risk group, the real-time US-guided placement of a central catheter into the IJV is associated with a low complication rate and a high success rate. Even under US guidance, experience lowers complication rates. Real-time USguided is recommended to be used routinely during central venous catheter insertion.

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Abdo, E. M., Abouelgreed, T. A., Elshinawy, W. E., Farouk, N., Ismail, H., Ibrahim, A. H., Kasem, S. A., Sakr , L. K., Aboelsoud , N. M., Abdelmonem, N. M., Abdelkader , S. F., Abdelwahed, A. A., Qasem, A. A., Alassal, M. F., & Aboomar, A. A. (2023). The outcome of ultrasound-guided insertion of central hemodialysis catheter. Archivio Italiano Di Urologia E Andrologia, 95(3). https://doi.org/10.4081/aiua.2023.11588