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Translumbar central venous catheters for long-term haemodialysis

Albert Power1, Seema Singh, Damien Ashby

  • 1Imperial College Kidney and Transplant Institute, West London Renal and Transplant Centre, Imperial College Healthcare Trust, Hammersmith Hospital, DuCane Road, London W12 0HS, UK. albert.power@imperial.nhs.uk

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|December 22, 2009
PubMed

Insights

Translumbar central venous catheters (CVCs) provide a safe and effective option for long-term haemodialysis access when conventional routes are unavailable. This study shows good dialysis adequacy and acceptable complication rates in patients with limited vascular access options.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Central venous catheters (CVCs) are used for haemodialysis in 23% of patients in the UK, Canada, and USA.
  • CVC use increases the risk of venous stenosis, limiting future vascular access options.
  • Translumbar approach is an alternative strategy for patients lacking conventional venous access.

Purpose of the Study:

  • To evaluate the safety and efficacy of translumbar inferior vena cava CVCs for haemodialysis.
  • To assess outcomes in patients with no other vascular access options.

Main Methods:

  • Retrospective analysis of patients receiving translumbar CVCs (TesioCath) between 1999-2008.
  • Examination of dialysis adequacy, complications, hospital admissions, and laboratory data.
  • Analysis of 39 CVC insertions in 26 patients with 15,864 catheter days.

Main Results:

  • All translumbar CVC insertions were successful, with one case of retroperitoneal haematoma.
  • Assisted primary patency was 81% at 6 months and 73% at 1 year.
  • Good dialysis adequacy (mean single-pool Kt/V 1.5) was achieved; infection rate was 2.84/1000 catheter days.

Conclusions:

  • Translumbar inferior vena cava CVCs provide a viable, safe, and effective long-term haemodialysis access.
  • This method is suitable for patients with exhausted conventional vascular access options.
  • The procedure demonstrated acceptable complication rates and good dialysis outcomes.
Abstract

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