[Dialock--an alternative to Permcath and access graft]

Area of Science:

• Nephrology
• Vascular Surgery
• Medical Devices

Background:

• Hemodialysis requires adequate vascular access, which is challenged by an aging patient population with increased comorbidities.
• Grafts and central venous catheters (CVCs) are common but associated with significant complications.
• The Dialock system is a subcutaneously implantable device designed to combine benefits of central venous access with percutaneous puncture for hemodialysis.

Purpose of the Study:

• To evaluate the safety and efficacy of the Dialock vascular access system in hemodialysis patients.
• To compare the performance of the Dialock system against traditional vascular access methods like grafts and CVCs.

Main Methods:

• A prospective study involving 26 Dialock system implantations over 30 months.
• Comparison with a control group of 22 hemodialysis patients with 47 vascular accesses and analysis of 110 patients with grafts.
• Data collection focused on infection rates, malfunctions, and need for interventions (PTA, thrombectomies).

Main Results:

• Dialock demonstrated significantly lower infection rates (exit site and bloodstream) per 1,000 hemodialysis access days compared to grafts and CVCs.
• The incidence of malfunctions was lower with Dialock than with CVCs.
• Grafts required more frequent interventions like percutaneous transluminal angioplasty (PTA) or thrombectomies compared to Dialock.

Conclusions:

• The Dialock access system is a safe and less complicated vascular access device for complex hemodialysis patients.
• With low infection and complication rates, Dialock presents a viable alternative to permanent CVCs and grafts.
• Careful application of the Dialock system is recommended for optimal outcomes in hemodialysis vascular access.