Percutaneous fibrin sleeve stripping of failing haemodialysis catheters

Background. One of the most frequent reasons for failure of haemodialysis l ines is catheter blockage caused by fibrin sheath formation. We report our experience of percutaneous fibrin sheath stripping in treating this problem . Methods. A consecutive series of failing haemodialysis catheters underwent percutaneous fibrin sheath stripping in an attempt to retrieve and prolong the life of the catheter. Immediate technical success, clinical success, an d primary and secondary patency were measured based on clinical follow-up. Results. Sixteen non-functional permanent haemodialysis lines in 15 patient s underwent percutaneous fibrin sheath stripping on 21 occasions. Technical success rate was 100%. Catheter Bow rates sufficient for initial dialysis were achieved in 12 (75%) lines. Successful percutaneous fibrin sheath stri pping produced a mean catheter patency of 126 days (range 6-299 days). Conclusions, Percutaneous fibrin sheath stripping is a simple, repeatable p rocedure that can usefully extend the life of a railing dialysis line. Howe ver, a randomized trial will be needed to evaluate its role compared with c atheter replacement.