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Use of Dacron cuffed silicone catheters as long-term hemodialysis access
D Shaffer1, P N Madras, M E Williams
1Division of Organ Transplantation, New England Deaconess Hospital, Boston, Massachusetts 02215.
Insights
Dacron cuffed central venous dialysis catheters offer long-term vascular access for hemodialysis patients. However, infection and thrombosis remain significant challenges impacting catheter survival rates.
Area of Science:
- Nephrology
- Vascular Access Surgery
Background:
- Chronic hemodialysis necessitates reliable vascular access.
- Central venous catheters are an option for permanent access, particularly in high-risk patients.
Purpose of the Study:
- To evaluate the long-term survival rates of Dacron cuffed, dual lumen, silicone central venous dialysis catheters.
- To identify the primary factors limiting the efficacy of these long-term catheters.
Main Methods:
- Retrospective analysis of 65 Dacron cuffed, dual lumen, silicone central venous dialysis catheters inserted in 51 patients.
- Calculation of actuarial survival rates at 6 and 12 months, both including and excluding revisions.
Main Results:
- Actuarial patient survival rates at 6 and 12 months were 53% and 35%, respectively.
- Actuarial catheter survival rates, including revisions, were 61% at 6 months and 43% at 12 months.
- Infection and thrombosis were identified as the main complications affecting catheter survival.
Conclusions:
- Dacron cuffed, dual lumen, central venous dialysis catheters can serve as a viable long-term vascular access solution for hemodialysis.
- Strategies to mitigate infection and thrombosis are crucial for improving the longevity of these devices.
Abstract:
Sixty-five Dacron cuffed, dual lumen, silicone central venous dialysis catheters (Quinton PermCath, Seattle, WA) were inserted in 51 patients as the sole form of permanent access for chronic hemodialysis. Six and 12 month actuarial survival rates of patients for all catheters were 53% and 35%, respectively. When calculations included revisions, 6 and 12 month actuarial catheter survival rates were 61% and 43%, respectively. The major limiting factors in survival using long-term catheters remain infection and thrombosis. Dacron cuffed, dual lumen, central venous, dialysis catheters can provide long-term vascular access for hemodialysis in high risk patients.