Nephrol Dial Transplant (1993) 8: 227-230
© 1993 European Renal Association-European Dialysis and Transplant Association
research-article
Subclavian catheter-related infection is a major risk factor for the late development of subclavian vein stenosis
1Nephrology University Hospital of Canary Islands, University of La Laguna Tenerife, Spain 2Radiodiagnosis Services, University Hospital of Canary Islands, University of La Laguna Tenerife, Spain
Correspondence and offprint requests to: Correspondence and offprint requests to: Dr Armando Torres, Avenida de Madrid 1, P2, 6B, 38007 Santa Cruz de Tenerife, Spain
Although subclavian vein stenosis is a well-known complication of haemodialysis subclavian catheters, little is known about its causes. Catheter-related infection is the most common complication of this technique, but its role in the genesis of late subclavian stenosis has not been established. We retrospectively analysed 80 subclavian catheterizations in a total of 54 chronic haemodialysis patients from a single center. Sixteen catheters had to be removed because of a well documented catheter-related infection: three catheter-related sepsis (2 with ipsilateral phlebitis), seven isolated fever with catheter tip colonization which disappeared after catheter removal, and six exit-site discharge with positive culture. For comparison we matched 14 contemporaneous catheters which were electively removed without evidence of infection and with a negative culture of the catheter tip. A venogram of the ipsilateral arm was performed in all the cases after more than 6 months of catheter removal. Both groups were remarkably similar with respect to age, sex, side of insertion, number of inserted catheters, time of indwelling, and time elapsed from removal to venography. Definite subclavian stenosis was three times more common among patients with previous catheter-related infection (75% versus 28%; P<0.01). Interestingly, both patients with ipsilateral phlebitis showed total occlusion of the subclavian vein. Although all diabetic patients of the study (n=6) suffered a catheter-related infection, the incidence of late subclavian stenosis was not more common than in non-diabetic infected patients.
In summary, subclavian haemodialysis catheter-related infection is a major risk factor for the development of late subclavian vein stenosis. Strict aseptic techniques and early removal of the catheter when infection is suspected, are important preventive measures.
Keywords: catheter-related infection; chronic haemodialysis; subclavian vein stenosis
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  V. Mickley Surgical alternatives to central venous catheters in chronic renal replacement therapy Nephrol. Dial. Transplant., June 1, 2003; 18(6): 1045 - 1051. [Full Text] [PDF]
|
|
|
|
|
|
V. Mickley Central venous catheters: many questions, few answers Nephrol. Dial. Transplant., August 1, 2002; 17(8): 1368 - 1373. [Full Text] [PDF]
|
|
|
|
|
|
J. Hegarty, M. Picton, N. Chalmers, and P. A. Kalra Iliac vein stenosis secondary to femoral catheter placement Nephrol. Dial. Transplant., July 1, 2001; 16(7): 1520 - 1521. [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Al-Wakeel, A. H. Milwalli, G. H. Malik, S. Huraib, S. Al-Mohaya, H. Abu-Aisha, and N. Memon Dual-Lumen Femoral Vein Catheterization as Vascular Access for Hemodialysis: A Prospective Study Angiology, July 1, 1998; 49(7): 557 - 562. [Abstract] [PDF]
|
|