Balloon Angioplasty for Disruption of Tunneled Dialysis Catheter Fibrin Sheath

PURPOSE: Management of failing tunneled hemodialysis catheters, sometimes the only vascular access for hemodialysis, presents a difficult problem. In spite of various techniques having been developed, no consensus has been reached about the preferred technique, associated with the longest catheter patency. METHODS: We report disruption of the fibrin sheath covering dysfunctional tunneled hemodialysis catheter by means of angioplasty, followed by over guidewire catheter exchange. RESULTS: Following the procedure, the catheter placed in the recovered lumen of the vessel presented correct function. CONCLUSIONS: The described procedure allowed maintenance of vascular access in our patient. Additionally, dilatation of the concomitant central vein stenosis opens an option for another attempt for arteriovenous fistula creation.