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A randomized, prospective evaluation of the Tesio, Ash split, and Opti-flow hemodialysis catheters
H M Richard1, G S Hastings, R L Boyd-Kranis
1Department of Diagnostic Imaging, Division of Interventional Radiology, University of Maryland Medical Systems, Baltimore, MD, USA. howard.richard@umm.edu
Insights
Opti-flow and Ash split catheters offer faster, easier insertion compared to Tesio catheters in hemodialysis. All three catheter types demonstrated comparable hemodialysis flow rates and survival outcomes.
Area of Science:
- Nephrology
- Vascular Access
- Medical Devices
Background:
- High-flow hemodialysis catheters are crucial for effective renal replacement therapy.
- Choosing the optimal catheter impacts procedural efficiency and patient outcomes.
Purpose of the Study:
- To prospectively evaluate and compare the performance of three high-flow hemodialysis catheters: Tesio, Ash split, and Opti-flow.
- To assess insertion characteristics, procedural complications, flow rates, and long-term outcomes.
Main Methods:
- A randomized trial involving 94 patients assigned to 113 Tesio, Ash split, or Opti-flow catheters.
- Data collected included insertion time, complications, ease of insertion, mean flow rates at specified intervals, patency, survival, and infection rates.
Main Results:
- Opti-flow and Ash split catheters showed significantly shorter insertion times and were easier to place than Tesio catheters.
- No significant differences were observed in mean hemodialysis flow rates among the three catheter types at baseline, 30, or 90 days.
- Catheter-related infection rates per 100 catheter days were 0.12 for Ash split, 0.35 for Opti-flow, and 0.14 for Tesio.
Conclusions:
- Opti-flow and Ash split catheters provide advantages in terms of insertion speed and ease compared to Tesio catheters.
- Hemodialysis flow rates and catheter survival did not differ significantly across the evaluated catheter types.
Purpose:
A randomized, prospective evaluation of three high-flow hemodialysis catheters.
Materials And Methods:
Ninety-four patients were randomly assigned 113 Tesio, Ash split, and Opti-flow catheters from December 1998 through June 1999. Insertion times, procedural complications, and ease of insertion were recorded. Mean catheter flow rates were recorded at first dialysis, 30 days, and 90 days. Patency, catheter survival, and catheter-related infections were evaluated.
Results:
Thirty-eight Ash split, 39 Opti-flow, and 36 Tesio catheters were placed. Tesio mean insertion time (41.5 min) was significantly longer than Ash split (29.4 min) or Opti-flow (29.6 min) (P =.004). There were four complications related to Tesio catheters (three cases of pericatheter bleeding, one air embolism), one related to an Opti-flow catheter (pericatheter bleeding), and zero related to Ash split catheters. Opti-flow and Ash split catheters were significantly easier to insert than Tesio catheters (P =.041). Mean flow rates were not significantly different among the catheters initially (P =.112), at 30 days (P =.281), or at 90 days (P =.112). Catheter-related infection rates per 100 catheter days were 0.12 for Ash split, 0.35 for Opti-flow, and 0.14 for TESIO: Median catheter survival was 302 days for Ash split, 176 days for Opti-flow, and 228 days for TESIO:
Conclusions:
Opti-Flow and Ash split catheters were faster and easier to place than Tesio catheters. There was no difference in hemodialysis flow rates or catheter survival.