Name of the Procedure:

External Cannula Declotting (separate procedure); without Balloon Catheter

Summary

External cannula declotting is a medical procedure used to remove clots from a cannula (a flexible tube inserted into the body) that is externally accessible, without using a balloon catheter. This tube can often become blocked by blood clots, and this procedure helps to clear it, ensuring it continues to function properly.

Purpose

External cannula declotting aims to restore normal function of the cannula when it is obstructed by blood clots. The expected outcome is to clear the blockage, allow for normal flow through the cannula, and prevent complications such as infection or impaired access for treatments like dialysis or medication administration.

Indications

• Blood clots detected in the cannula
• Reduced or blocked flow through the cannula
• Swelling, pain, or discomfort at the cannula site
• Diagnosis of thrombosis (clot formation) in cannula patients

Preparation

• The patient may need to fast for a few hours before the procedure.
• Blood tests and clotting profiles might be conducted to assess the risk of bleeding.
• Current medications might be reviewed, and any anticoagulants may be adjusted or temporarily stopped.

Procedure Description

1. The patient is positioned comfortably, and local anesthesia is applied to the area around the cannula.
2. The skin and cannula area are sterilized.
3. A special declotting agent or saline solution is injected into the cannula to dissolve or flush out the clot.
4. A small needle or syringe may be used to manually extract clots if necessary.
5. The cannula is then checked to ensure that it is clear and functioning properly.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

This procedure is usually performed in a hospital outpatient clinic or a specialized treatment center.

Personnel

• A vascular surgeon or interventional radiologist performs the procedure.
• Nursing staff assists with preparation and post-procedure care.
• An anesthetist may be present if sedation is required.

Risks and Complications

• Infection at the cannula site
• Bleeding or hematoma formation
• Damage to the cannula, requiring replacement
• Recurrence of clot formation
• Pain or discomfort during the procedure

Benefits

• Immediate restoration of cannula function
• Improved blood flow or medication delivery
• Prevention of complications related to blocked cannulas, such as infection or thrombosis

Recovery

• Patients may rest for a short period after the procedure.
• The cannula site should be kept clean and dry.
• Follow-up appointments may be necessary to ensure the cannula remains patent.
• Restrictions on heavy lifting or strenuous activities might be advised for a few days.

Alternatives

• Ballon catheter declotting: involves the use of a balloon to clear the clot.
• Surgical replacement of the cannula: in cases where declotting is not possible or effective.
• Pharmacological thrombolysis: using medication to dissolve the clot.

Patient Experience

Patients may feel some pressure or slight discomfort during the procedure but should not experience significant pain. Post-procedure, there might be minor soreness at the cannula site. Pain management can include over-the-counter pain relievers, and comfort measures such as applying a cold pack to the area if recommended by the healthcare provider.