Objective:Malignant ascites presents difficult management issues in the palliative care population and results in distressing symptoms and recurrent hospital admissions.The palliative care services in Our Lady of Lour...Objective:Malignant ascites presents difficult management issues in the palliative care population and results in distressing symptoms and recurrent hospital admissions.The palliative care services in Our Lady of Lourdes Hospital have been using radiologically guided tunneled peritoneal catheters for the palliative therapy of troublesome malignant ascites.We conducted a review of this management strategy.Methods:There were 10 catheters inserted in 9 patients between May 2007 and June 2011 in patients with malignant ascites.Results:There were no procedural related mortalities or major complications.Mean catheter life was 98.9 days.Post catheter re-hospitalization rate was 1.55 times per patient.Mean patient survival post insertion was 140 days.Eighty eight percent of patients achieved death at home.Conclusion:We conclude that this is a safe and useful strategy in the management of malignant ascites in a palliative care population.展开更多
Establishing a long-term vascular access in patients exhibiting vascular access exhaustion is challenging. In this study, we reported a case of a direct catheterization in the superior vena cava of a hemodialysis pati...Establishing a long-term vascular access in patients exhibiting vascular access exhaustion is challenging. In this study, we reported a case of a direct catheterization in the superior vena cava of a hemodialysis patient with vascular access exhaustion and original dysfunctional catheter inserted via the left internal jugular vein. The direct catheterization was performed with cuffed tunnel catheter （CUFF） and guided by digital subtraction angiography （DSA） and multidetector computedtomography venography （MDCTV）. The DSA and MDCTV results revealed an occlusion in the right innominate vein and thromboses in the left innominate, right internal jugular, subclavian, and femoral veins. The distal end of the superior vena cava was localized clearly by the original CUFF under DSA. Directed at the distal end of the superior vena cava, a 0.5-cm secondary puncture was introduced below the lateral head of the sternocleidomastoid muscle via the right neck area. This study is one of the few reports regarding direct catheterization of CUFF via the superior vena cava of a patient with vascular access exhaustion and CUFF dysfunction on the left internal jugular vein. We believe that our study can provide a new alternative for inserting central venous catheter for such patient.展开更多
文摘Objective:Malignant ascites presents difficult management issues in the palliative care population and results in distressing symptoms and recurrent hospital admissions.The palliative care services in Our Lady of Lourdes Hospital have been using radiologically guided tunneled peritoneal catheters for the palliative therapy of troublesome malignant ascites.We conducted a review of this management strategy.Methods:There were 10 catheters inserted in 9 patients between May 2007 and June 2011 in patients with malignant ascites.Results:There were no procedural related mortalities or major complications.Mean catheter life was 98.9 days.Post catheter re-hospitalization rate was 1.55 times per patient.Mean patient survival post insertion was 140 days.Eighty eight percent of patients achieved death at home.Conclusion:We conclude that this is a safe and useful strategy in the management of malignant ascites in a palliative care population.
文摘Establishing a long-term vascular access in patients exhibiting vascular access exhaustion is challenging. In this study, we reported a case of a direct catheterization in the superior vena cava of a hemodialysis patient with vascular access exhaustion and original dysfunctional catheter inserted via the left internal jugular vein. The direct catheterization was performed with cuffed tunnel catheter （CUFF） and guided by digital subtraction angiography （DSA） and multidetector computedtomography venography （MDCTV）. The DSA and MDCTV results revealed an occlusion in the right innominate vein and thromboses in the left innominate, right internal jugular, subclavian, and femoral veins. The distal end of the superior vena cava was localized clearly by the original CUFF under DSA. Directed at the distal end of the superior vena cava, a 0.5-cm secondary puncture was introduced below the lateral head of the sternocleidomastoid muscle via the right neck area. This study is one of the few reports regarding direct catheterization of CUFF via the superior vena cava of a patient with vascular access exhaustion and CUFF dysfunction on the left internal jugular vein. We believe that our study can provide a new alternative for inserting central venous catheter for such patient.
