Do you recommend immediate catheter removal or anticoagulating for a certain amount of time before removing the tunneled dialysis catheter of a patient with an incidentally found, asymptomatic thrombus at the end of the catheter that does not interfere with hemodialysis?

Answer from: at Community Practice

I agree with Dr. @Ramin Sam. Since this tunneled dialysis catheter (TDC) is functioning well, there is no urgency to remove it. Infact, removal runs the risk of dislodging the thrombus causing pulmonary embolism. I would provide systemic anticoagulation with a vitamin K antagonist (coumadin) using t...

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at Valley Nephrology Associates
Coumadin increases risk of calciphylaxis. Does Ta...

Answer from: at Academic Institution

It depends on the size of the thrombus. In general, I prefer anticoagulation first, repeat ultrasound after 6 months and then decide whether to remove the catheter. Most of the time, I find there is significant decrease in size of the clot with anticoagulation alone.

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Do you recommend immediate catheter removal or anticoagulating for a certain amount of time before removing the tunneled dialysis catheter of a patient with an incidentally found, asymptomatic thrombus at the end of the catheter that does not interfere with hemodialysis?

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