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New insertion support device assisted the accurate placement of tunneled cuffed catheter: First experience of 10
Toshiaki Ohara1,2, Kazufumi Sakurama2,3, Satoshi Hiramatsu3
11 Department of Pathology & Experimental Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Insights
A new device accurately guides tunneled cuffed catheter placement in hemodialysis patients, improving safety and reducing waste. This insertion support device ensures precise catheter positioning, minimizing complications and the need for replacements.
Area of Science:
- Nephrology
- Vascular Access
- Medical Device Development
Background:
- Tunneled cuffed catheters are crucial for hemodialysis when other access methods are unsuitable.
- Accurate placement is vital for safe hemodialysis but challenging due to anatomical variations.
- A novel device has been developed to aid in the precise placement of these catheters.
Purpose of the Study:
- To evaluate the clinical efficacy of a newly developed device for supporting tunneled cuffed catheter insertion.
- To assess the accuracy and safety of catheter placement using the device.
- To report the initial clinical experience with this innovative insertion support tool.
Main Methods:
- A device was fabricated from processed expanded polytetrafluoroethylene to maintain shape and plasticity.
- The device was used externally to mark the catheter path and exit site on the patient's skin.
- Ten patients underwent tunneled cuffed catheter insertion guided by the device's markings.
Main Results:
- The device facilitated safe and accurate placement of tunneled cuffed catheters in all ten patients.
- Catheter tips were consistently positioned in the right atrium with a mean placement error of 0.70 ± 0.48 cm.
- All catheters remained patent without complications or replacement during the study period.
Conclusions:
- The novel insertion support device significantly enhances the safety of tunneled cuffed catheter placement.
- The device effectively prevents catheter malposition and reduces associated waste and complications.
- This technology offers a promising solution for improving hemodialysis vascular access procedures.
Introduction:
The tunneled cuffed catheter is used in hemodialysis patients for whom an arteriovenous fistula or arteriovenous graft is not suitable or for bridging usage of them. Accurate placement of a tunneled cuffed catheter is necessary for safe hemodialysis, but placement is sometimes difficult because of individual body differences. We developed a new device to support accurate placement of the tunneled cuffed catheter. In this study, we report our first clinical experience of the device.
Methods:
We made the device by expanded polytetrafluoroethylene with some special processes. The processes enable it to maintain plasticity and temporary shape in the autoclaved condition. The device is laid on the surface of the patient's body to mark the root of the catheter with a felt-tipped marker before catheterization. That enables us to know the accurate catheter root and tunneled cuffed catheter exit site on the body surface. Ten patients underwent tunneled cuffed catheter insertion according to the marking.
Case Description:
The mean age was 71.3 ± 12.8 years. The tunneled cuffed catheter was safely placed according to the marking in all patients, and all catheter tips were placed in the right atrium. The mean verification tip location difference before and after catheterization was 0.70 ± 0.48 cm. This result indicated that the device could assist in inserting a catheter accurately within an error of 1.18 cm. The tunneled cuffed catheters were patent in all the cases, without replacement and complications until the end of bridging use or during the observation period.
Conclusion:
Our newly developed insertion support device enhances safety and prevents catheter waste during replacement.
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