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Percutaneous cuffed catheter insertion by nephrologists
D Choudhury1, Z Ahmed, H I Girgis
1Division of Nephrology, Wilmington Veterans Affairs Hospital, Wilmington, Del., USA.
Insights
Nephrologists can safely place Dacron cuff permanent catheters for hemodialysis using a peel-away technique. This method offers a viable alternative to surgical placement while patients await permanent vascular access, with minimal complications observed.
Area of Science:
- Nephrology
- Vascular Access Procedures
Background:
- Dacron cuff double-lumen permanent catheters are increasingly used for hemodialysis.
- These catheters serve as a temporary solution while patients await permanent vascular access.
- Surgeons traditionally perform catheter placement, but nephrologists possess relevant skills.
Purpose of the Study:
- To evaluate the feasibility and safety of nephrologist-performed percutaneous placement of Dacron cuff permanent catheters.
- To assess the complication rates associated with this technique in a non-operating room setting.
Main Methods:
- Percutaneous placement of 77 Dacron cuff permanent catheters.
- Performed by 4 nephrologists across two medical centers.
- Utilized the available peel-away insertion technique in a non-operating room setting.
Main Results:
- Successful placement of all 77 catheters.
- Minimal complications were reported during the procedures.
- Demonstrates the efficacy of the peel-away technique for nephrologists.
Conclusions:
- Nephrologists can effectively extend their skills to place Dacron cuff permanent catheters.
- Percutaneous placement using the peel-away technique is a safe and effective alternative to surgical placement.
- This approach facilitates timely vascular access for hemodialysis patients.
Abstract:
The use of Dacron cuff double-lumen permanent catheters for hemodialysis has become more common in the dialysis unit as patients await for creation or maturation of a permanent hemoaccess for various reasons. Placement of these catheters is often done by surgeons. Nephrologists skilled in the placement of temporary central vein accesses can extend their skill to placement of cuff catheters with the current available peel-away insertion technique. Data are presented on the percutaneous placement of 77 Dacron cuff permanent catheters by 4 nephrologists in two medical centers in a nonoperating room setting with minimal complications.