Clinical Utility of the Buttonhole Technique Using Biohole(TM) in Hemodialysis Patients.
- Author:
Soo Jeong CHOI
1
;
Seol Hyoung LEE
;
Eun Hee CHO
;
Hye Ran OH
;
Eun Jung KIM
;
Moo Yong PARK
;
Jin Kuk KIM
;
Seung Duk HWANG
Author Information
1. Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea. sd7hwang@schmc.ac.kr
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Buttonhole;
Arteriovenous shunt;
Renal dialysis
- MeSH:
Bleeding Time;
Catheterization;
Dislocations;
Europe;
Hemorrhage;
Hemostasis;
Humans;
North America;
Punctures;
Renal Dialysis
- From:Korean Journal of Medicine
2012;82(3):307-312
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Buttonhole cannulation has been popular because it provides an easy puncture, is less painful, and requires less time for hemostasis. However, the technique requires a skilled staff and a long time to form the tract. A new buttonhole technique using Biohole(TM), which shortens the time needed for tract formation, has been introduced in Europe, North America, and Japan. METHODS: We prepared a cannulation tract using the buttonhole technique and Biohole(TM) over a two-week period and compared the 12-week outcomes between patients who underwent the rope-ladder versus buttonhole techniques. RESULTS: The 40 patients (27 males) had a mean age of 49.1 +/- 14.2 years. Thirteen and 27 patients were cannulated with the rope-ladder and buttonhole techniques, respectively. Patients who underwent the buttonhole technique had more initial pain than did those who received the rope-ladder technique (p = 0.044). The Biohole(TM) procedure improved puncture pain (5.6 vs. 3.4, p = 0.003) and shortened hemostasis time (1.8 vs. 1.3, p = 0.001). Over a two-week period, patients using Biohole(TM) experienced dislocation (20.8%), bleeding at peg sites (8.6%), and pain during peg change (2.4%). Over the 12 week study period, patients who underwent the buttonhole technique had insignificantly less pain than did those who received the rope-ladder technique (p = 0.088), but the former had less bleeding time than the latter (p = 0.000). One patient who received the buttonhole technique experienced one episode of infection (p = 0.327). CONCLUSIONS: The new buttonhole technique using Biohole(TM) is safe and useful in the short term. A long-term, larger, multicenter study is required to confirm these results.
