الفهرس 
Anatomy of the LiverOnly 14 pages are availabe for public view
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Abstract
Background : chronic renal failure and the need of vascular access for regular renal dialysis
are considered as one of the main health problems nowadays. So long-term dependency on
catheter-based dialysis needs unconventional approaches for catheter placement like transhepatic
veins.
Objective: This study aimed to evaluate the functionality and detect the complications of the
trans-hepatic long-term hemodialysis catheters (permcath) as well as the durability and the long term efficacy of each hepatic vein access in the chronic hemodialysis patients with exhausted
venous conventional accesses.
Patients and Methods: 33 CKD patients with exhausted venous accesses were enrolled
in the study for transhepatic permcath insertion. Then the indications, procedure details,
functional time periods of catheters, reasons for the removal or revision of catheters, catheter related complications, and current conditions of patients were prospectively analyzed.
Results: A total of 39 catheters were properly placed in 33 patients (100% technical success)
under imaging guidance during the 27-month follow-up period. Mean of primary and secondary
devices service intervals were 185 and 187 days respectively. Mean time catheter in situ was 200
days. Mean cumulative duration of catheter in situ was 236.5 days. The rates of catheters
migration, sepsis, thrombosis, and exit site infection rates were low. No mortality or other
complications were related to the procedure.
Conclusion : The transhepatic access is a safe and functional long term venous access in
chronic hemodialysis in patients with exhausted venous accesses due to satisfy