Effectiveness of recanalisation with micropuncture in placement of dialysis catheter in patients with central venous occlusion

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Abstract
Purpose: Central venous occlusion represents a major obstacle to establishing reliable dialysis access. This study was designed to systematically evaluate the outcomes of utilising the micropuncture technique for catheter placement in patients with central venous obstruction. Materials and methods: A retrospective analysis was conducted on 20 patients with central venous occlusion undergoing micropuncture-assisted recanalisation between July 2020 and March 2023. Patient demographics, procedural details and outcomes were collected. Success rates were evaluated based on catheter functionality and optimal positioning, while complications were categorised using the CIRSE classification system. Results: Recanalisation was successfully performed in 17 out of 20 patients (85%), with short-segment occlusions demonstrating superior success rates (92.8%) compared to long-segment occlusions (66.6%). Acute and subacute thrombus cases showed higher recanalisation success (100% and 87.5%) compared to chronic thrombus cases (50%). No major complications occurred, while minor haematomas were observed in four patients (20%). The mean catheter patency was 11 months, and the primary patency rate at 12 months was 70%. Conclusion: The micropuncture technique is a safe and effective option for catheter placement in patients with central venous occlusion. Its low complication rates and high technical success highlight its utility in clinical practice, particularly for patients with limited vascular access options.

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