Successful use of cuffed central venous hemodialysis catheters inserted percutaneously.

Abstract

Although endogenous fistulae and grafts are preferred for permanent hemodialysis access, central venous catheters are often required for varying intervals when creating permanent access is not feasible. The prospective experience with 118 catheters in over a 3.5-yr period is reported; 93 (79%) were placed by percutaneous techniques, and 25 (21%) were placed by operative techniques. Seventy seven catheters (65%) were placed in the subclavian vein, 36 (31%) were placed in the internal jugular vein (usually right side), and 5 (4%) were placed in the femoral vein. Early postplacement complications were infrequent. Catheter function at last local follow-up ranged from several days to nearly 2 yr, averaging approximately 3 mo, even though many patients returned to their referring centers with a functioning catheter after only a short follow-up. Actuarial survival for percutaneously placed catheters was approximately 60% at 6 mo and 30% at 12 mo. Catheter failure occurred in 36% of cases, equally divided between malfunction (thrombosis refractory to fibrinolysis, extrusion, kinking, or related event) and infection with septicemia requiring removal. Such failure was not more frequent after percutaneous placement than after operative placement. Failure due to mechanical malfunction, but not that due to infection, tended to be less frequent among catheters placed in the internal jugular vein than among catheters placed in the subclavian vein. Finally, infection with septicemia involved 22% of all catheters and occurred at an average cumulated rate of approximately one infection per patient-year. Coagulase-positive staphylococcus was the most common organism isolated.(ABSTRACT TRUNCATED AT 250 WORDS)

The impact of spontaneous echo contrast on tunneled dialysis catheter patency

“…Catheter thrombosis is the most common reason for catheter removal and re-insertion. [12][13][14] Until today, many studies have been conducted on catheter thrombosis, and many risk factors such as sex, race, catheter insertion site, diabetes mellitus, and locking solutions have been identified. [15][16][17][18] It has been found on occasion that even if there is no mechanical problem associated with the catheter, in some patients, TDC loses functionality in a shorter time than expected, and the necessity of frequent intra-catheter thrombolytic therapy arises.…”

Variables Leading to Usage of Alteplase Versus Heparin Lock in Patients With Tunneled Catheters in Hemodialysis Care Project Centers, Saudi Arabia

“…The KDOQI Vascular Access Guideline Work Group considers a sufficient extracorporeal blood flow to be 300 ml/min [ 2 ]. Approximately 50% of HD catheters fail within one year [ 3 ]; up to two-thirds of the failures are due to thrombosis [ 4 - 5 ].…”

A Randomized Controlled Trial of Comparative Efficacy between Sodium Bicarbonate and Heparin as A Locking Solution for Tunneled Central Venous Catheters Among Patients Requiring Maintenance Hemodialysis

“…3 Approximately 50% of CVC failed within 1 year 4 and up to two-thirds of failures were due to thrombosis. 5 The clinical impact of CRT is poorer clearance of uremic toxins, such as decreased KT/V. In addition, CRT was also associated with increased risks of missing dialysis session, hospitalization, and mortality.…”