Insertion of Permanent haemodialysis catheters through the great saphenous vein

Abstract

Aim-BackgroundIn patients with end stage renal disease when there is inability or contraindication for the creation of a direct arterio-venous fistula or the use of a graft, the insertion of a permanent hemodialysis catheter in a central vein ensures the conduction of haemodialysis. We present a technique of placing a permanent haemodialysis catheter in the inferior vena cava through the great saphenous vein. The aim of this study is to show that the above technique is simply, safe and reliable.Patients-MethodsOver the study period, from January 2002 to December 2010, 12 haemodialyzed patients, (8 females and 4 males), with a mean age of 73 years (range 62–91 years), were referred from different renal units for placement of a dialysis catheter through the great saphenous veins. In all patients, the alternative sites of a permanent haemodialysis catheter insertion in the major branches of the superior vena cava had been extensively used. The procedure was performed under local anaesthesia, ECG monitoring, and fluoroscopic control. The insertion of the tunnelled haemodialysis catheters was accomplished with ease, through surgical exposure of the great saphenous vein, without the need for a guidewire.ResultsThe haemodialysis catheter’s function was assessed intraoperatively (blood flow>350 ml/min). No intraoperative or immediate post operative complications were noted. The primary catheter patency duration was recorded, which varied from 28 to 845 days (mean±SD=294±243,3).ConclusionThe introduction of dialysis catheters into the inferior vena cava through the great saphenous vein is technically simple with rare complications and with highly successful results.