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Abstract: SA-PO1082

Surfacer Inside-Out Access Procedure for Effective and Quick Placement of Venous Catheters in Patients with Thoracic Central Venous Obstruction

Session Information

  • Vascular Access - II
    November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 704 Dialysis: Vascular Access

Authors

  • Sengoelge, Gurkan, Medical University of Vienna, Vienna, Austria
  • Reindl-Schwaighofer, Roman, Medical University of Vienna, Vienna, Austria
  • Gallieni, Maurizio, Ospedale San Carlo Borromeo - ASST Santi Paolo e Carlo - University of Milano, Milano, Italy
  • Steinke, Tobias, Schön Klinik Düsseldorf, Düsseldorf, Germany
  • Ebner, Adrian, Centro de Intervenciones Endovasculares, Asuncion, Paraguay
  • Brunkwall, Silke K., Vascular Center, University hospital Malmö, Sweden, Malmö, Sweden
  • Matoussevitch, Vladimir, Vascular Access Unit, University of Cologne, Germany, Köln, Germany
Background

Thoracic central venous obstruction (TCVO) associated with repeated insertion or prolonged use of central venous catheters (CVCs) is common in hemodialysis populations. The Surfacer System to Facilitate Access in Venous Occlusions (SAVE) Registry was designed to evaluate the performance of the Surfacer, a novel inside-out procedure for patients with limited or diminishing upper body venous access or pathology impeding standard access methods. During this prospective, single-arm, multicenter, international registry, the Surfacer System was integrated during routine clinical care to facilitate right-sided placement of CVCs in patients with TCVO.

Methods

Five sites enrolled 30 patients in the SAVE Registry. Enrollment occurred between February 2017 and September 2018. Patient demographics, medical history and type of TCVO based on Dolmatch et al (J Vasc Interv Radiol. 2018;29:454-460) were collected at enrollment. Twenty-nine of the 30 patients with TCVO required CVCs for hemodialysis and 1 for chronic apheresis. Surfacer performance (success rate of CVC placement, procedural and fluoroscopy time), device-related adverse events, catheter malpositionings and postprocedural complications were documented during the procedure and upon hospital discharge.

Results

Baseline venography revealed 30% of patients had Type 4 occlusions, 26.7% had Type 3, 16.7% has Type 2, and 26.7% had Type 1. Successful CVC placement was achieved in 29 patients (96.7%). Mean completion time was 24 ±14.9 minutes, mean fluoroscopy time was 6.8 ± 4.5 minutes and mean contract volume use was 29.7 ± 22.2. The procedure was discontinued in 1 patient (3.3%) due to significant vascular anatomical tortuosity. There were no adverse events or complications.

Conclusion

The Surfacer Inside-Out access procedure enables effective, safe and quick placement of right-sided venous catheters in patients with thoracic central venous obstructions.