Ron Wong Cheuk Lau*, Eric Cheung Wai Pan, Agnes Wong, Brian Lee Kar Ho, Cheng Ka King and Danny Cho Hing Yan
Objective: To evaluate the efficacy and safety of fluoroscopic-guided repositioning of Peritoneal Dialysis (PD) catheter using guidewire manipulation in our center from Hong Kong.
Methods: All patients underwent fluoroscopic-guided peritoneal dialysis catheter repositioning in our institution between 1st November 2017 to 31st December 2022 were reviewed. Patients fulfilling the selection criteria were identified, with their clinical notes, relevant radiological reports, interventional images and operative records retrospectively reviewed. The success rate was evaluated, with the technical success defined as improved contrast spillage, or return of continuous steady stream after test injection of normal saline immediately after repositioning; clinical success defined as functional peritoneal dialysis catheter after 30 days of repositioning. Logistic regression models were applied to evaluate the variables associated with successful manipulation. Post manipulation complications and the PD time gained after successful manipulation were also reviewed. Results: 46 patients were identified and 54 procedures were performed over the study period. 35 of the interventions (64.8%) resulted in technical success, and 25 cases (46.3%) resulted in clinical success. The median extra PD time gained after successful manipulation was 619 days (IQR, 313.5-1007); (range, 110-1872). The median for number of days of hospital stay after the procedure was 2.5 days (IQR, 2-5), (range, 1-65). 7 cases (13.0%) developed immediate complications, with most cases being peritonitis (n=5), and all were successfully treated with intraperitoneal antibiotics. There was no associated mortality. Objective: To evaluate the efficacy and safety of fluoroscopic-guided repositioning of Peritoneal Dialysis (PD) catheter using guidewire manipulation in our center from Hong Kong.
Methods: All patients underwent fluoroscopic-guided peritoneal dialysis catheter repositioning in our institution between 1st November 2017 to 31st December 2022 were reviewed. Patients fulfilling the selection criteria were identified, with their clinical notes, relevant radiological reports, interventional images and operative records retrospectively reviewed. The success rate was evaluated, with the technical success defined as improved contrast spillage, or return of continuous steady stream after test injection of normal saline immediately after repositioning; clinical success defined as functional peritoneal dialysis catheter after 30 days of repositioning. Logistic regression models were applied to evaluate the variables associated with successful manipulation. Post manipulation complications and the PD time gained after successful manipulation were also reviewed.
Results: 46 patients were identified and 54 procedures were performed over the study period. 35 of the interventions (64.8%) resulted in technical success, and 25 cases (46.3%) resulted in clinical success. The median extra PD time gained after successful manipulation was 619 days (IQR, 313.5-1007); (range, 110-1872). The median for number of days of hospital stay after the procedure was 2.5 days (IQR, 2-5), (range, 1-65). 7 cases (13.0%) developed immediate complications, with most cases being peritonitis (n=5), and all were successfully treated with intraperitoneal antibiotics. There was no associated mortality.
Conclusion: Fluoroscopic-guided repositioning of the peritoneal dialysis catheter was found to be a useful and safe treatment option for malfunctioned peritoneal dialysis catheter and could potentially spare patients from the conventional operative intervention.
Published Date: 2025-02-20; Received Date: 2024-09-24
