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?
Community PollStarted
How do you manage an incidentally found, asymptomatic thrombus at the end of a tunneled dialysis catheter that does not interfere with hemodialysis?
55 physicians have voted
Join Mednetto vote and see how they answered.
2 Answers
Mednet MemberInvited Expert
Nephrology · LSU Health Sciences Center - Shreveport
Answered on
I agree with Dr. @Dr. First Last. 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) us...
Join for free or sign in to see the full answer
Mednet MemberInvited Expert
Nephrology · University Of California San Francisco Medical Center At Parnassus
Answered on
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.
Join for free or sign in to see the full answer