Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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NOT_YET_RECRUITING
NA
52 participants
INTERVENTIONAL
2023-01-01
2026-01-01
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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Percutaneous translumbar permcath
* Local anesthesia in adults and general anesthesia in pediatrics.
* The patient under fasting condition is placed prone on angiography table.
* Skin preparation and a sterile draping of the operating field.
* Puncture site is chosen 1.5 cm above right iliac crest 10 cm lateral to the posterior median line.
* Puncture into inferior vena cava is made using 21 gauge 15 cm long needle, inserted at 45 degree angle from the horizontal and advanced medially and superiorly under us then fluoroscopic guidance.
* Entry into the IVC is made below the level of the renal veins, immediately anterior to the 3rd lumber vertebra.
* Intravascular position of the needle is confirmed by free aspiration of blood and injection of contrast media under fluoroscopy.
* A guide wire is introduced through the needle and advanced well into the IVC.
* The needle is replaced with a dilator. A catheter of appropriate length is tunneled subcutaneously from the right flank and advanced to the IVC
Percutaneous translumbar and transhepatic permcath
For selected ESRD patients who have exhausted all conventional access routes , translumbar and transhepatic insertion of long term hemodialysis catheters provide additional sites for access
Percutaneous transhepatic permcath
* The patient lies in supine position.
* The procedure is done under local anesthesia.
* Under ultrasound guidance; access by a 21 gauge angiocatheter (15cm) to right or middle hepatic vein through intercostal or subcostal approach.
* Entrance of the hepatic veins is confirmed by injection of diluted contrast media (iopromide) under fluoroscopy.
* A 0.018-inch guidewire is advanced through the needle and into the right atrium.
Intravascular catheter length is measured and selected in standard fashion.
* The initial access needle is exchanged over the guidewire for a coaxial transitional sheath, which permits replacement of the 0.018-inch guidewire with a 0.035-inch guidewire.
* The tunneled catheter is inserted over the wire through a peel-away sheath
Percutaneous translumbar and transhepatic permcath
For selected ESRD patients who have exhausted all conventional access routes , translumbar and transhepatic insertion of long term hemodialysis catheters provide additional sites for access
Interventions
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Percutaneous translumbar and transhepatic permcath
For selected ESRD patients who have exhausted all conventional access routes , translumbar and transhepatic insertion of long term hemodialysis catheters provide additional sites for access
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
2. Patients on long term anticoagulants
3. Concurrent active infection.
4. Sgnificant abdominal ascites. (transhepatic)
5. Cirrhotic liver disease patients. (transhepatic)
6. Morbid obesity. (translumbar)
5 Years
75 Years
ALL
No
Sponsors
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Assiut University
OTHER
Responsible Party
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Abdallah Morsy Mohamed Khalil
Dr
Central Contacts
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References
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Kade G, Les J, Buczkowska M, Labus M, Niemczyk S, Wankowicz Z. Percutaneous translumbar catheterization of the inferior vena cava as an emergency access for hemodialysis - 5 years of experience. J Vasc Access. 2014 Jul-Aug;15(4):306-10. doi: 10.5301/jva.5000185. Epub 2013 Nov 4.
Lorenz JM. Unconventional venous access techniques. Semin Intervent Radiol. 2006 Sep;23(3):279-86. doi: 10.1055/s-2006-948767.
Napalkov P, Felici DM, Chu LK, Jacobs JR, Begelman SM. Incidence of catheter-related complications in patients with central venous or hemodialysis catheters: a health care claims database analysis. BMC Cardiovasc Disord. 2013 Oct 16;13:86. doi: 10.1186/1471-2261-13-86.
Farag YMK, El-Sayed E. Global Dialysis Perspective: Egypt. Kidney360. 2022 Apr 20;3(7):1263-1268. doi: 10.34067/KID.0007482021. eCollection 2022 Jul 28. No abstract available.
Zouaghi MK, Lammouchi MA, Hassan M, Rais L, Krid M, Smaoui W, Jebali H, Kheder R, Hamida FB, Moussa FB, Fatma LB, Beji S. Determinants of patency of arteriovenous fistula in hemodialysis patients. Saudi J Kidney Dis Transpl. 2018 May-Jun;29(3):615-622. doi: 10.4103/1319-2442.235183.
Other Identifiers
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Unconventional permcath
Identifier Type: -
Identifier Source: org_study_id