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Tesio-Caths provide effective and safe long-term vascular access.
Neill D C Duncan1, Seema Singh, Thomas D H Cairns
1Renal and Transplant Unit, St Mary's Hospital, London, UK. neillduncan@hotmail.com
Summary
Tesio-Caths, a type of central venous catheter, offer effective dialysis adequacy for patients unable to form arteriovenous fistulas. This vascular access method demonstrates comparable survival rates and acceptably low complication rates.
Area of Science:
- Nephrology
- Vascular Surgery
- Medical Devices
Background:
- Vascular access is crucial for dialysis adequacy, durability, and complication rates.
- Arteriovenous fistula (AVF) formation is ideal but not feasible for all patients.
- Tesio-Caths, twin-line single-lumen central venous catheters, are explored for maximizing dialysis in challenging cases.
Purpose of the Study:
- To evaluate the large-scale use of Tesio-Caths in patients unsuitable for AV fistula.
- To assess dialysis adequacy, functional access survival, and complication rates associated with Tesio-Caths.
Main Methods:
- Retrospective study of patients with Tesio-Cath insertion between January 1999 and October 2002.
- Analysis of 623 Tesio-Caths in 435 patients, covering 7464 patient-months of follow-up.
- Evaluation of dialysis adequacy (single-pool Kt/V), access survival, patient survival, and complication rates.
Main Results:
- High initial functionality rate (95.3%) for Tesio-Caths.
- Mean dialysis adequacy (Kt/V) of 1.5+/-0.3, with 68% achieving Kt/V >1.4.
- One-year and three-year functional access survival rates of 77.8% and 44%, respectively.
- Low access-related infection (0.28 admissions/1000 catheter days) and dysfunction (0.33/1000 patient years) rates.
Conclusions:
- Tesio-Caths provide effective dialysis adequacy for patients where AV fistulas are not an option.
- Patient and functional access survival are comparable to European data for various vascular access types.
- Complication rates associated with Tesio-Cath use are acceptably low.