Hector Ferral MD, Presenter: Nothing to Disclose

Aditi Gulab Gulabani MD, Abstract Co-Author: Nothing to Disclose

To determine if patients under anticoagulant and / or antiplatelet therapy have higher bleeding complications after tunneled dialysis catheter placement compared to patients with no therapy.

Retrospective study conducted between 7/2009 and 7/2010. A total of 119 patients underwent tunneled dialysis catheter placement. Sixty-nine patients were on anticoagulant, antiplatelet therapy or a combination as follows: Aspirin (n=25), Coumadin (n=5), Plavix (n=3), IV Heparin (n=2), subcutaneous Heparin 5,000 units BID (n=17), combination of anticoagulant and antiplatelet therapy (n=17). Fifty patients had no therapy; an abnormal coagulation profile (INR> 1.5, platelet count < 50,000) was identified in 9 of these patients. The bleeding complications were compared between the two groups.

Dialysis catheter placement was successful in all patients. A total of 5/69 (7.2%) patients received transfusion of blood products before catheter placement in the therapy group and 6/50 (12%) patients in the control group (p=NS). A total of 2/69 (2.9%) patients in the treatment group received transfusions after the procedure and 3/50 (6%) in the control group. A total of 2/119 ( patients had a bleeding complication after tunneled dialysis catheter placement 2/119 (1.7% ). None of the patients in the treatment group experienced bleeding after dialysis catheter placement and 2 patients in the control group had bleeding at catheter site insertion (p= NS). No other complications were identified. There was 1 death in the treatment group and this was not considered to be directly related to the procedure.

No differences in bleeding complications were identified between these 2 groups. Overall, bleeding complications after tunneled dialysis catheter placement are low. A randomized prospective trial would be useful to further determine therapy guidelines in these patients.

This work addresses the important issue regarding antiplatelet/anticoagulant therapy and risk of bleeding during a procedure. No significant differences were found in our study group.

Ferral, H, Gulabani, A, Bleeding Complications in Patients Undergoing Tunneled Dialysis Catheter Placement: Retrospective Comparison between Patients with and without Anticoagulant and Platelet Inhibitor Therapy.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034466.html