MO770: Are There Any Differences in Survival According to the Type of Tunnelled Central Venous Catheters?

Abstract

Abstract BACKGROUND AND AIMS An elevated proportion of haemodialysis patients require at some point the utilization of a tunnelled central venous catheter (tCVC) as vascular access. There are several designs for tCVC that differ in the type of material used, the number of lumens, length and tip design. Currently, a scarcity of studies has compared the different types of tCVC. The aim of this study was to analyse whether there were differences in catheter survival between three types of tCVC: symmetrical-tip, step-tip and split-tip catheters. METHOD We conducted a prospective observational study that included all incident patients in two haemodialysis centres between 2016 and 2020, with a minimum follow-up of 6 months (until June 2021). The election of tCVC type was performed by the interventional radiologist in a random manner according to available tCVC. We collected demographic data (age, sex, dialysis site), comorbidities (diabetes mellitus, Charlson Index), laboratory values (albumin, haemoglobin, C-reactive protein), dialysis adequacy (KtV, dose of urokinase used for maintaining tCVC patency) and a number of tCVC used. RESULTS Table 1 shows the characteristics of the 182 tCVC included in this study, stratified in three groups according to the type of tip, without observing significant differences. We did not find significant differences in catheter survival between the three types of tCVC, neither globally nor after adjusting for other confounding variables. However, catheter survival decreased after the second tCVC independent of the type of tCVC (cumulative incidence: tCVC 1 versus >1: 180 days 7% versus 32%; 360 days 10% versus 34%; 720 days 11% versus 34%, P = 0.001) Catheter survival also decreased in patients >70 years old (cumulative incidence <70 versus >70 years: 360 days 7.6% versus 20%; 720 days 10.8% versus 21.1%, P = 0.035) CONCLUSION There are no differences in catheter survival between the three types of tCVC. The patency of vascular access decreases with age and the number of previously used catheters, being both independent risk factors for catheter dysfunction.