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Updated: Apr 30, 2026
Author Spotlight: Hickman Catheter Use for Long-Term Vascular Access in a Preclinical Swine Model
Published on: March 31, 2023
Dialysis central venous catheter types and performance
Maurizio Gallieni1, Irene Brenna, Francesca Brunini
12 Specialty School of Nephrology, University of Milan, Milan - Italy.
Insights
Choosing central venous catheters (CVCs) for hemodialysis requires balancing cost and quality to minimize complications like infections and thrombosis. Research focuses on improving CVC design for better long-term function and reduced patient risk.
Area of Science:
- Nephrology
- Vascular Access
- Biomaterials
Background:
- Central venous catheters (CVCs) are crucial for hemodialysis but associated with significant complications.
- Catheter-related infections, thrombosis, and inefficient dialysis lead to severe patient outcomes and high healthcare costs.
- Selecting the appropriate CVC involves navigating diverse characteristics and costs.
Purpose of the Study:
- To review general features of central venous catheters (CVCs) used in hemodialysis.
- To compare tunneled versus nontunneled CVCs.
- To discuss factors influencing CVC performance and complication rates.
Main Methods:
- Review of CVC types, materials, and design features.
- Analysis of clinical implications of different CVC characteristics.
- Discussion of catheter coatings and their impact on complications.
Main Results:
- CVC design is a key area of research aiming to enhance long-term function and reduce complications.
- Differences in CVC design (tunneled vs. nontunneled, straight vs. precurved) impact clinical outcomes.
- Material compatibility, lumen design, tip configuration, and coatings are critical factors.
Conclusions:
- Optimizing CVC selection and design is essential for improving patient care and reducing healthcare expenditure.
- Further research into CVC features can lead to significant improvements in complication and reintervention rates.
- A balance between CVC quality and cost is necessary for effective hemodialysis management.
Abstract:
The choice of both short-term (nontunneled) and long-term (tunneled) central venous catheters (CVCs) for hemodialysis is a difficult one, due to the large number of available catheters, with very different characteristics and cost.CVC-related complications (in particular infections, thrombosis and inefficient dialysis) can determine ominous consequences and death, with extremely elevated costs due to prolonged hospitalization and expensive procedures. Thus, the correct balance between cost and quality of CVC is required when deciding which kind of CVC should be adopted.In this regard, the design of CVCs has become a very active area of industrial and clinical research, with the ultimate goal of improving the long-term function of the catheter and of reducing complication rates, because even small improvements in the complication or reintervention rates have a positive impact on individual patient care and cost to society. In this article we review the general features of CVCs, including differences between tunneled and nontunneled CVCs, materials and their compatibility with lock solutions, the implications of straight versus precurved design in nontunneled CVCs, lumen and tip features with their clinical implications, catheter coatings and their effect on infection and thrombosis.
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