Basics of Tunneled Dialysis Catheter Placement for Haemodialysis – Single Centre Experience

Sabarinath Eada,Uma Maheswara Reddy V Uma Maheswara Reddy V,K S Amitha Vikrama K S Amitha Vikrama,Saripudi Svnp Manikanta Vijay Saripudi Svnp Manikanta Vijay,Pavithira Annamalai,Yugandhar Samireddypalle

doi:10.47009/ajmrr.2020.8.1.26

Abstract

/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.

Highlights

The incidence of end stage renal disease is on the rise and most of these patients are undergoing hemodialysis mainly through four types of vascular access: Arterio-Venous fistulas (AVF), Arterio-Venous grafts(AVG), Tunneled dialysis catheters (TDC), Non-Tunneled central vein catheters
The tunneled dialysis catheters act as bridge dialysis devices during maturation period of arteriovenous fistulas/grafts and serve as the last option for end stage renal disease patients who have exhausted all the other dialysis accesses
Tunneled dialysis catheters act as bridge hemodialysis devices till the maturation of AVF/AVG and as a last resort for patients who have exhausted all other options

Summary

Introduction

The incidence of end stage renal disease is on the rise and most of these patients are undergoing hemodialysis mainly through four types of vascular access: Arterio-Venous fistulas (AVF), Arterio-Venous grafts(AVG), Tunneled dialysis catheters (TDC), Non-Tunneled central vein catheters.The tunneled dialysis catheters act as bridge dialysis devices during maturation period of arteriovenous fistulas/grafts and serve as the last option for end stage renal disease patients who have exhausted all the other dialysis accesses. The incidence of end stage renal disease is on the rise and most of these patients are undergoing hemodialysis mainly through four types of vascular access: Arterio-Venous fistulas (AVF), Arterio-Venous grafts(AVG), Tunneled dialysis catheters (TDC), Non-Tunneled central vein catheters. The incidence of end stage renal disease is on the rise and most of these patients are undergoing dialysis either through tunneled /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 serve as the last option for end stage renal disease patients who have exhausted all the other dialysis accesses. 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 for improving catheter function

Methods

Results

Discussion

Conclusion