Abstract: Objective  To study the clinical application of percutaneous transluminal balloon angioplasty (PTA) for removal of the stuck cuffed catheter and re-catheterization in situ.  Methods  Clinical data of the 11 patients with stuck tunneled cuffed catheter in the Department of Nephrology, the Second Affiliated Hospital of Bengbu Medical College during the period between November 2018 and October 2021 were retrospectively analyzed. The stuck tunneled cuffed catheters in these patients were detected during the replacement of tunneled cuffed catheter when removal of the catheters by regular technique was impossible. According to the inner diameter of the tunneled cuffed catheter, balloons of various diameters on operating rod were imported to expand the whole length of the vessel in which the original dialysis catheter located. After release of the fibrin sheath, the stuck tunneled cuffed catheter was removed, and a larger balloon was used for further expansion of the fibrin sheath. A new tunneled cuffed catheter was then placed in situ. The clinical efficacy of the PTA operation was followed up for 5～35 months.  Results  The stuck cuffed catheters were removed following PTA in all 11 patients. A new cuffed catheter was successfully placed in situ in 10 patients. No operation-related complications occurred, including heart arrhythmia, central venous rupture, hemo-pneumothorax, mediastinal hematoma, cardiac tamponade and other complications. During the followed-up period, one patient underwent kidney transplantation, and one died of multiple myeloma; their blood access volumes were 200 and 240 ml/min. The blood access volumes were 220-240ml/min in other patients.  Conclusion  PTA for removal of the stuck cuffed catheter and replacement of a new cuffed catheter in situ is a safe and efficient operation, which should be recommended as the first choice for treatment of the stuck hemodialysis cuffed catheters.

Key words: Stuck tunneled cuffed hemodialysis catheter, Percutaneous transluminal angioplasty, Re-catheterization, Maintenance hemodialysis