{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T02:07:54Z","timestamp":1788746874684,"version":"build-2803163510"},"reference-count":8,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T00:00:00Z","timestamp":1727136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T00:00:00Z","timestamp":1727136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>End\u2010stage renal disease (ESRD) patients frequently encounter challenges at the time of dialysis catheter insertion from concomitantly associated with thoracic central venous obstruction (TCVO). TCVO complicates the placement of tunnelled dialysis catheters (TDCs). In cases where TCVO is unexpectedly encountered and TDC insertion becomes difficult, central venoplasty followed by catheter reinsertion is required. This report details a novel technique to salvage a TDC that was trapped at the TCVO site after removal of the peel\u2010away sheath. We describe the case of a 67\u2010year\u2010old diabetic male ESRD patient on haemodialysis since 2017, with history of multiple prior accesses, who presented with acute thrombosis of his arteriovenous fistula. TDC placement was attempted via the left internal jugular vein (IJV). Angiography revealed severe stenosis at the left brachiocephalic vein\u2010superior vena cava confluence, necessitating venoplasty. Post\u2010venoplasty, the TDC could not be advanced past the IJV venous entry site due to unfavourable catheter tip profile. Utilising a double guidewire railroad technique, the TDC was successfully reinserted, ensuring functional dialysis. The technique carries potential risks, which mandates careful hemodynamic monitoring and prophylactic measures. In conclusion, percutaneous placement of a TDC following a central venoplasty is at times life\u2010saving in patients with exhausted peripheral vascular access and concomitant TCVO. In the absence of a peel\u2010away sheath, TDC reinsertion using a double guidewire railroad technique is a helpful technique for salvaging the catheter, especially in financially\u2010constrained settings.<\/jats:p>","DOI":"10.1111\/nep.14395","type":"journal-article","created":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T09:21:41Z","timestamp":1727169701000},"page":"977-980","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Central venoplasty followed by \u2018double guidewire railroad technique\u2019 as a bailout strategy in difficult tunnelled dialysis catheter insertion"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6521-0943","authenticated-orcid":false,"given":"Shabna","family":"Sulaiman","sequence":"first","affiliation":[{"name":"Department of Nephrology IQRAA International Hospital and Research Centre  Calicut India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul","family":"Razik","sequence":"additional","affiliation":[{"name":"Department of Radiology IQRAA International Hospital and Research Centre  Calicut India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.tvir.2016.11.008"},{"issue":"1","key":"e_1_2_7_3_1","first-page":"45","article-title":"Prevalence and risk factors of central venous stenosis among prevalent hemodialysis patients, a single center experience","volume":"7","author":"Osman OO","year":"2014","journal-title":"Arab J Nephrol Transplant"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfh216"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1708538117728866"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.5301\/jva.2010.4717"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.53555\/jptcp.v30i17.2750"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.4103\/0971\u20104065.120354"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2014.11.035"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.14395","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nep.14395","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.14395","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T01:32:03Z","timestamp":1788744723000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.14395"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,24]]},"references-count":8,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1111\/nep.14395"],"URL":"https:\/\/doi.org\/10.1111\/nep.14395","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,24]]},"assertion":[{"value":"2024-06-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}