Factors affecting long-term survival of tunnelled haemodialysis catheters a prospective audit of 812 tunnelled catheters

Abstract

Clinicians need accurate data regarding catheter survival, mode of insertion and design, to inform practice.

The Different Impacts on the Long-Term Survival of Tunneled Internal Jugular Hemodialysis Catheters Based on Tip Position and Laterality

“…The quality of hemodialysis is often associated with adequate blood flow rates, which are improved when the tip is positioned in the right atrium, but many clinicians still have the fear that right atrium thrombus or arrhythmia would be developed. Some data adversely associate left-sided access with catheter durability [7] although without mentioning the exact reason. The aim of this study was to examine the impact of different catheter tip positions on catheter duration, dysfunction, infection, and quality of hemodialysis and possible differences between the access site laterality in jugular-tunneled hemodialysis catheters.…”

Minocycline-EDTA Lock Solution Prevents Catheter-Related Bacteremia in Hemodialysis

“…The type of infections comprise exit-site infection, tunnel infection, and bacteremia. Despite the fact that exit-site and tunnel infections are the most common complications, 3,4 catheter-related bacteremia (CRB) is the most serious one, representing a barrier to long-term catheter use and emerging as a significant cause of morbidity and mortality. 5 Some studies have demonstrated that in patients using a hemodialysis catheter, the risk of death is 1.5-to threefold higher when compared with patients with a primary arteriovenous fistula.…”

Placement of a Hemodialysis Catheter using the Dilated Right External Jugular Vein as a Primary Route

“…When the use of the IJV is not feasible, other venous routes such as the EJV or femoral vein for catheter placement are usually selected. When conventional venous routes are exhausted, unusual venous access routes such as the brachiocephalic vein, and translumbar and transhepatic routes have been attempted by interventional radiologists with a relatively higher complication rate (5)(6)(7)(11)(12)(13)(14)(15)(16)(17).…”

“…Several studies have reported that the left IJV approach had relatively higher rates of stenosis and thrombosis compared to the right IJV approach (1,13,14,30,31). Our thinking is that the catheter passes through the narrow space between the sternum and aortic arch, and can cause injury or may induce stenosis by close approximation of the catheter tip to the wall of the superior vena cava.…”