Usefulness of the alpha maneuver in the peritoneal catheter displacement: review and experience

Abstract

Introduction and objectives: Peritoneal catheter displacement is one of the most common complications of peritoneal dialysis. The alpha manoeuvre has been proposed as a repositioning technique, which involves returning the catheter to its correct position using rigid guidewires under fluoroscopic guidance. The aim of this study is to analyse the 107 procedures performed at our Centre to identify factors that may predict the success of the technique.

Material and methods: The alpha manoeuvre method was used in 86 patients, with a total of 107 procedures (70 patients underwent one manoeuvre only, 16 patients underwent two or more manoeuvres).

Results: The overall success rate of the technique was 60%. There were no differences in success rate in terms of gender (60% male vs. 40% female, p = 0.104), time of catheter failure (early 60% vs. late 62%, p = 0.849), type of catheter (75% self-locating vs. 58% spiral, p = 0.633) or the initial position of the catheter. There was only one case of peritonitis related to the procedure.

Conclusions: The alpha manoeuvre is an effective and safe method for correcting peritoneal catheter displacement.

Keywords: Alpha maneuver; Displacement of the peritoneal catheter; Diálisis peritoneal; Malposición del catéter peritoneal; Maniobra alfa; Peritoneal dialysis.