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    Endoluminal dilatation for embedded hemodialysis catheters: A case-control study of factors associated with embedding and clinical outcomes - Fig 1

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    <p>Endoluminal Dilation: (A, B and C) An 8 x 80mm balloon is inserted over a guidewire into the venous lumen of an embedded tunneled dialysis catheter and inflated along the length of the catheter from its distal tip to the cuff. Balloon inflation pressure of between 12 (rated burst pressure) and 20atm is used and maintained until there is complete or near complete effacement of areas of narrowing, assumed to represent the principle points of tethering of the catheter to the venous wall. The catheter is then easily removed. (D and E) If performing a catheter exchange, a 0.035inch guidewire is inserted through the arterial lumen of the embedded catheter just before its removal and used for insertion and inflation of a 12 x 40mm balloon along the length of the SVC and brachiocephalic vein. The balloon is then removed followed by insertion of a new tunneled dialysis over the guidewires and through the initial subcutaneous tract.</p
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