Fractured Femoral Catheter Tip in Repeated Femoral Vein Cannulation for Haemodialysis Vascular Access

Abstract

Percutaneous insertion of haemodialysis HD catheters can be readily performed by the bedside in any of the accessible central veins, for immediate use in patients requiring dialysis. The femoral, internal jugular or subclavian veins are the favoured sites for catheter insertion. Although the jugular and subclavian access routes are more commonly used than the femoral vein for haemodialysis because of higher incidence of thrombosis and infections seen in femoral vein cannulations, the femoral route is still considered less risky. First, there is no risk of pneumothorax and secondly, the site is directly compressible should bleeding occur. Therefore, the frequency of life-threatening complications is lower for femoral cannulation than for the other sites. However, life-threatening complications do occur in femoral cannulations. Here we describe a case of fractured catheter tip with development of extensive deep vein thrombosis that was successfully managed in our hospital. The problems encountered in the management of the patient are highlighted