Abstract: FR-PO0560
Outcomes of Fluoroscopic Tenckhoff Catheter Repositioning: Impact of Etiology of Malfunction and Preprocedural Catheter Position
Session Information
- Home Dialysis: Clinical Epidemiology
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Shum, Tung sen, Division of Nephrology, Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, Hong Kong
- Cheuk, Au, Division of Nephrology, Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, Hong Kong
Background
Peritoneal dialysis (PD) is the most common modality of renal replacement therapy in Hong Kong because of the "PD-First" policy. Catheter malfunction remains a significant clinical challenge. Fluoroscopic repositioning is a minimally invasive procedure for patients with catheter malfunction refractory to conservative management. This technique is safe, rapid, and allows immediate resumption of PD post-procedure. However, evidence on the impact of malfunction etiology and pre-procedural catheter position on outcomes remains limited.
Methods
This retrospective analysis included 32 consecutive PD patients from 2022 to 2024, with catheter malfunction refractory to conservative measures. Fluoroscopic repositioning using a double guidewire technique was performed. Clinical outcomes were analysed for all patients, with comparisons between omental wrap and migration groups, and evaluation of pre-procedural catheter tip position (pelvic vs. non-pelvic). Success (restored dialysate flow) was evaluated at 1 and 3 months.
Results
Mean age was 58.3 ± 16.5 years, 53.1% male. No intergroup differences in age, sex, BMI, time to malfunction (median 21[IQR8–103]d), repositioning delay (median 27[IQR15–49]d) or surgical history (p > 0.05). Overall success was 46.9% (15/32) at 1month, 43.8% (14/32) at 3months. Etiology-driven outcomes revealed significantly higher 1-month success for migration (85.7% [6/7]) versus omental wrap (33.3% [8/24]; p=0.009), with sustained durability at 3 months (71.4% [5/7] vs. 33.3% [8/24]; p=0.07). Non-pelvic catheters trended toward higher 1-month success (55.0% [11/20] vs. 33.3% [4/12]; p=0.30), with all migration cases originating from non-pelvic positions (p<0.001). 93.3% (14/15) of 1-month successes persisted at 3 months. No complications occurred.
Conclusion
Fluoroscopic Tenckhoff Catheter Repositioning is a safe procedure with 46.9% overall success at 1 month, demonstrating 93.3% durability at 3 months for initial successes. It is particularly effective for migrated catheters (85.7% 1-month success). Catheter tip located at non-pelvic region before procedure trended toward better outcomes (55.0% vs. 33.3%), aligning with migration etiology. Omental wrap’s low success (33.3%) advocates for adjunctive strategies, e.g. surgical intervention. These findings emphasize etiology-driven management to optimize technique survival.