Effectiveness evaluation of hand technic for improve suction of the vessel wall by the vascular access hemodialysis catheters

Abstract

Vascular access hemodialysis catheters are mainly used for vascular access in patients with acute renal failure. Catheter dysfunction during dialysis may be caused by suction of the vessel wall, thrombotic occlusion. A thrombus can be removed from a within catheter using a syringe. However, this procedure won’t work if the arterial pore of the catheter causes suction of the vessel wall. Although attempts are made to solve this problem by repositioning the catheter and using a saline solution syringe, this procedure is not necessarily right. This study aimed to solve this problem by only repositioning the catheter. There are no published reports on using real-time monitoring to assess suction of the vessel wall by the catheter. Without such monitoring, medical staff cannot confirm that suction is the cause of catheter dysfunction in any particular case. We established an ex vivo evaluation system for quantifying and visually confirming that a catheter adheres to the vessel wall by suction. Using this model, we evaluated techniques to resolve the problem. One possibility is to withdraw the catheter slightly, while another rotates it. Withdrawing the catheter did not resolve the suction in all cases. Rotating the catheter had a higher success rate, depending on the rotation angle. However, even this method was not uniformly successful. We provide a method that enables easy observation of suction of the vessel wall by visual observation. Our results may prove helpful in solving this common problem.