'Long-term' catheters for haemodialysis: malfunction and management

The purpose of this study is to demonstrate the incidence of dysfunction due to thrombosis of the central venous catheters (tunnelized and siliconic) for haemodialysis. We have also correlated the rate of the thrombotic events to the site of positioning and to the different protocols used in order to prevent these complications. Femorals are more affected by thrombosis, partial or total, than jugular catheters. The mean request of the urokinase-boluses is low : only 10% of the dialytic sessions examined (1200) requires these interventions. A significant reduction is obtained if to the patients are administered ASA. No influence seems to result from the use of the anticoagulants. Our study confirms in our population the advantages of central venous catheters in chronic haemodialysis, the ease of management and the absence of serious complications during the observation period (6 months).