Basics of Tunneled Dialysis Catheter Placement for Haemodialysis – Single Centre Experience
Basics of Tunneled Dialysis Catheter Placement for Haemodialysis
/non tunneled dialysis catheters or through arteriovenous fistulas/grafts. The tunneled dialysis catheters act as bridge dialysis devices during maturation period of arteriovenous fistulas/grafts and also serve as the last option for end stage renal disease patients who have exhausted all the other dialysis accesses. The aim and objective is to review the basic key concepts of internal Jugular, External Jugular and Subclavian tunneled venous catheter placement, techniques utilized, complications encountered, issues of suboptimal functioning and their management. Subjects and Methods: This was a prospective observational study done in department of Radio diagnosis, Narayana medical college, Nellore. About 54 cases were performed in our institution from December 2018 to Mar 2020 (including three pediatric patients). The age range of these patients is 10 to 75 years. Results: Out of 54 cases, one case had failed, as the guide wire didn’t pass across the brachiocephalic vein. Venogram revealed high grade stenosis of right brachiocephalic vein. There were major complications in two cases, minor complications in five cases with delayed complications in two cases. Conclusion: Tunneled catheters play a key role in serving as bridging devices during maturation of AVF/AVG or as the last option in chronic kidney disease patients in whom all other options have exhausted. Intervention radiologist should have good experience and an overall knowledge of the issues involved in placement of tunneled dialysis catheters, knowledge about the complications, technical issues of suboptimal functioning, for optimal catheter placement and also for improving catheter function.
Ash SR. Advances in Tunneled Central Venous Catheters for Dialysis: Design and Performance. Semin Dial. 2008;21(6):504–515. Available from: https://dx.doi.org/10.1111/j.1525-139x.2008.00494.x.
Pereira K, Osiason A, Salsamendi J. Vascular Access for Placement of Tunneled Dialysis Catheters for Hemodialysis: A Systematic Approach and Clinical Practice Algorithm. J Clin Imaging Sci. 2015;5:31–36. Available from: https://dx.doi.org/10.4103/2156-7514.157858.
Siegel JB. Tunneled Dialysis Catheters: Pearls and Pitfalls. J Vasc Interv Radiol. 2008;11:181–185. Available from: https://dx.doi.org/10.1053/j.tvir.2008.09.005.
Yevzlin AS, Chan M, Gimelli G. How I Do It: Preferential Use of the Right External Jugular Vein for Tunneled Catheter Placement. Semin Dial . 2008;21(2):183–185. Available from: https://dx.doi.org/10.1111/j.1525-139x.2007.00415.x.
Sulek CA, Blas ML, Lobato EB. A randomized study of left versus right internal jugular vein cannulation in adults. J Clin Anesth. 2000;12(2):142–145. Available from: https://dx.doi.org/10.1016/s0952-8180(00)00129-x.
Clark E, Kappel J, MacRae J, Dipchand C, Hiremath S, Kiaii M, et al. Practical Aspects of Nontunneled and Tunneled Hemodialysis Catheters. Can J Kidney Health Dis. 2016;3:2054358116669128. Available from: https://dx.doi.org/10.1177/2054358116669128.
Bagul A, Brook NR, Kaushik M, Nicholson ML. Tunnelled Catheters for the Haemodialysis Patient. Eur J Vasc Endovasc Surg. 2007;33(1):105–112. Available from: https://dx.doi.org/10.1016/j.ejvs.2006.08.004.
Aydin Z, Gursu M, Uzun S, Karadag S, Tatli E, Sumnu A, et al. Placement of Hemodialysis Catheters with a Technical, Functional, and Anatomical Viewpoint. Int J Nephrol. 2012;2012:1–5. Available from: https://dx.doi.org/10.1155/2012/302826.
Wang K, Wang P, Liang XH, Yuan FF, Liu ZS. Cuffed- tunneled hemodialysis catheter survival and complications in pediatric patients: a single-center data analysis in China. Int J Clin Exp Med. 2015;8(6):9765–9765.
Ervo R, Cavatorta F, Zollo A. Implantation of Permanent Jugu- lar Catheters in Patients on Regular Dialysis Treatment: Ten Years’ Experience. J Vasc Access. 2001;2(2):68–72. Avail- able from: https://dx.doi.org/10.1177/112972980100200209.
Aiken G, Porteous L, Tracy M, Richardson V. Cardiac tamponade from a fine silastic central venous catheter in a premature infant. J Paediatr Child Health. 1992;28(4):325–327. Available from: https://dx.doi.org/10.1111/j.1440-1754.1992.tb02679.x.
Azevedo AC, de Lima IF, Brito V, Centen MJ, Fernandes A. Cardiac tamponade: a rare complication of central venous catheter–a clinical case report. Rev Bras Anestesiol. 2018;68(1):104–112. Available from: https://doi.org/10.1016/j.bjane.2015.04.005.
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