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Nephrology • Interventional Nephrology
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 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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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...