Chinese Journal of Blood Purification ›› 2019, Vol. 18 ›› Issue (11): 772-775.doi: 10.3969/j.issn.1671-4091.2019.11.011

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Dilemma of double lifelines: pacemaker and tunnel-cuffed catheter

  

  1.  1Department of Nephrology and 2Department of Cardiology, Haidian Hospital (Haidian Section of Peking University Third Hospital), Beijing 100080, China
  • Received:2019-02-12 Revised:2019-09-04 Online:2019-11-12 Published:2019-10-28

Abstract:

【Abstract】Objective To explore the feasibility of implanting tunneled cuffed catheter (TCC) through internal jugular vein in the presence of heart pacemaker leads and the co-existence of catheters and leads. Methods Seventeen patients with pacemaker leads were recruited from the Department of Nephrology, Beijing Haidian Hospital from April 2014 to August 2018. TCCs were implanted under digital subtraction angiography (DSA) for these patients. The position of pacemaker electrode and leads and the function of pacemaker were examined during and after the operation. The infection around catheter and pacemaker lead, the symptomatic venous hypertension, and the ease of catheter removal were observed during the follow- up period. Results In the 17 patients, the tips of the catheters were successfully placed in the upper-middle part of right atrium in 15 patients, the catheter was implanted after balloon dilatation of the superior vena cava stenosis in one patient, and the catheter tip was first bumped the pacemaker wire and then arrived to upper-middle part of right atrium after adjustment of the tip direction in one patient. During and after the operation, the pacemaker electrodes and leads were not displaced and the functions of the pacemakers were normal. There were no pacemaker lead infection and pacemaker dysfunction during the follow-up period. One patient developed catheterrelated infection after the catheterization for one year but without infection of the pacemaker leads; the infection was cured after anti- infective therapy and replacement of the catheter. Mild swelling of upper limb occurred in one case, but no clinical intervention was required. The catheters were replaced in situ in 9 cases, and no catheter got stuck during removal of the original catheters. Conclusions In patients with pacemaker leads but without severe vascular stenosis, the implanting of TCC under DSA was highly successful and safe. The coexistence of catheters and pacemaker leads did not cause infection around pacemaker lead and pacemaker dysfunction at least in a short follow-up period. Symptomatic venous hypertension was rare.

Key words: Hemodialysis, Pacemaker lead, Tunnel-cuffed catheter, Symptomatic venous hypertension, Catheter-related infection

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