Conversion to a permanent vascular catheter from a temporary vascular catheter using a guidewire

Abstract

Recently, the number of patients requiring vascular access points involving a permanent vascular catheter (PVC) (particularly dialysis patients in whom creating an arteriovenous fistula would be difficult, e.g., because of cardiovascular dysfunction and/or long‒term bed rest) or a temporary vascular catheter (TVC) (e.g., patients who require incident dialysis or have occluded vascular access points) has increased. Central venous catheterization can cause various complications, such as artery puncture, hematoma formation, and pneumothorax. In the present study, we investigated the validity and safety of a surgical technique for the orthotopic exchange of a TVC for a PVC using a guidewire, with the aim of reducing the risk of complications of PVC insertion. We reviewed the cases of 87 patients who underwent PVC insertion at our center between April 2017 and April 2020. We compared the results of 27 patients who underwent orthotopic TVC exchange for a PVC using a guidewire with those of 60 patients who underwent catheter insertion at a new site. There were no significant differences in patient background factors between the groups. In addition, we observed no significant difference with regards to the complications rate, operating time, catheter‒related infections, or the short‒term patency rate. The patients who underwent guidewire‒based exchange reported no complications. Thus, these results suggest that the orthotopic exchange of a TVC for a PVC using a guidewire may be clinically useful.