LEARNING FROM IMAGES Fundamental Mistake During Tunneled Hemodialysis Catheter (TDC) Removal

LEARNING FROM IMAGES Fundamental Mistake During Tunneled Hemodialysis Catheter (TDC) Removal Michael J. Kelly, Siddiq Anwar, Tushar Vachharajani, Maciej Karasek and Saeed Ahmed 1 1 Sunderland Royal Hospital, UK 2 W.G. (Bill) Hefner Veterans Affairs Medical Center, Salisbury, NC, USA Tunneled hemodialysis catheter (TDC) removal is relatively a safe procedure with common complications that include bleeding, soreness and scar. Less common complications of tethering, air embolus, fibrin sheath embolization and pulmonary embolus have been reported [1, 2]. 62-year-old female with end stage renal disease due to obstructive uropathy initially commenced hemodialysis via a TDC (BIO-FLEX TESIO CATH, Medcomp, Harleys-ville, PA) in March 2014. Once her permanent access had matured, 9 months after insertion, a decision was made to remove her TDC.