Insertion of tunneled hemodialysis catheters without fluoroscopy

Elias, Rosilene Motta
da Silva Makida, Sonia Cristina
Abensur, Hugo
Martins Castro, Manuel Carlos
Affonso Moysés, Rosa Maria
Pereira, Benedito Jorge
de Oliveira, Rodrigo Bueno
Luders, Cláudio
Romão, João Egidio Jr

Nephrology Division, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo - Brazil

Address for correspondence:

Rosilene Motta Elias

Hospital das Clinicas da FMUSP, Disciplina de Nefrologia

Rua Dr. Enéas de Carvalho Aguiar 255, 7° andar

São Paulo, São Paulo, Brazil, ZIP 05403-000

[email protected]

The Journal of Vascular Access 11(2):p 138-142, April-May-June 2010.

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 nontunneled 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.