Insertion of tunneled hemodialysis catheters without fluoroscopy

J Vasc Access. 2010 Apr-Jun;11(2):138-42. doi: 10.1177/112972981001100210.

Abstract

Background: The tunneled cuffed catheter (TCC) is used as a bridge access for hemodialysis. Few prospective studies have been designed to evaluate conversion from non-tunneled to TCC without the use of fluoroscopy when performed by nephrologists.

Methods: We performed an observational prospective cohort in incident patients receiving hemodialysis through a non-tunneled right jugular vein catheter.

Results: 130 procedures were performed in 122 patients (51+/-18 years). The success rate was 100%. There was a total of 26,546 catheter days. Ninety-one of the 130 catheters were removed during the study period. Life table analysis revealed primary patency rates of 92%, 82%, and 68% at 30, 60, and 120 days, respectively. Infection requiring catheter removal occurred at a frequency of 0.09 per 100 catheter days. Catheter malfunction requiring intervention occurred at a rate of 0.03 per 100 catheter days. Hypertension and duration of existing non-tunneled catheter of less than 2 weeks were independently associated with better TCC survival.

Conclusion: The conversion from non-tunneled to TCC performed by nephrologists and without fluoroscopy may be safe by using the internal right jugular vein. The ideal time to do this procedure is within less than 2 weeks of existing non-tunneled catheter.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brazil
  • Catheter-Related Infections / etiology
  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / instrumentation*
  • Catheterization, Central Venous / methods
  • Catheters, Indwelling* / adverse effects
  • Device Removal
  • Equipment Failure
  • Fluoroscopy
  • Humans
  • Jugular Veins* / diagnostic imaging
  • Kaplan-Meier Estimate
  • Life Tables
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Radiography, Interventional
  • Renal Dialysis*
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Young Adult