TTSH using new technique to make dialysis easier, safer for patients

A local hospital is employing a ground-breaking technique to make life easier - and safer - for many dialysis patients.

It addresses a particularly risky aspect of dialysis - the fact that a single vein in the neck becomes the only lifeline for some patients.

If this vein gets blocked, doctors must insert a groin catheter, which is prone to infection and other problems.

Tan Tock Seng Hospital (TTSH) has been using a new method since July to allow dialysis to continue through an opening in the neck, even if the veins there are blocked.

Associate Professor Pua Uei, a senior consultant in TTSH's diagnostic radiology department, told The Straits Times yesterday: "This is one of the safest and quickest ways to salvage something that we had no good answers to before."

The new technique involves threading a fine wire up a different vein till it reaches the blocked area. It is then pushed through the person's body until it exits near the collarbone. A regular catheter is then attached for dialysis to take place.

"Under X-ray guidance, this is very safe," Prof Pua noted.

TTSH is the first hospital in Asia to perform this surgery. It is done under local anaesthesia and takes 30 to 45 minutes. The procedure has been carried out on three elderly patients so far.

A person is diagnosed with kidney failure here every five hours. Figures in 2016 show there were more than 6,600 dialysis patients in Singapore.

Though most patients who undergo blood dialysis do so through a vein in their arms, around 20 per cent use long-term neck catheters. TTSH doctors insert over 400 such catheters a year but around 40 per cent develop blocked veins.

"When that happened, we used to have to move on to the next vein... and eventually we would run out of veins in the neck we could use," Prof Pua said.