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Effects of different catheter replacement methods on catheter service time and complications in hemodialysis

Haibo Yu1, Qi Xin2, Xuewen Wang3

  • 1Kidney Disease and Blood Purification Treatment Department, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China.

The Journal of Vascular Access
|December 11, 2019
PubMed

Insights

Ectopic catheter replacement improves patency rates for long-term vascular access, though it requires surgical skill. This method offers a better prognosis for dialysis catheter service time compared to in situ replacement.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Central venous catheters are used for long-term vascular access when arteriovenous fistulas are not feasible.
  • Catheter malfunction necessitates replacement, prompting investigation into different replacement methods.

Purpose of the Study:

  • To evaluate complications and service duration of central venous catheters replaced via ectopic versus in situ methods.
  • To identify factors influencing the service time of dialysis catheters.

Main Methods:

  • Retrospective observational cohort study of patients undergoing tunneled dialysis catheter replacement (2009-2019).
  • Comparison of ectopic replacement versus in situ replacement techniques.
  • Analysis using Cox proportional hazards regression model to determine influencing factors.

Main Results:

  • Ectopic replacement demonstrated improved primary and auxiliary primary patency rates.
  • Catheter service time was influenced by ectopic replacement technique and catheter tip shape, increasing with patient age.
  • The initial catheter insertion generally had the longest service time and fewest complications.

Conclusions:

  • Ectopic catheter replacement can enhance catheter patency and prolong service life.
  • Sufficient surgical expertise and potentially digital subtraction angiography are crucial for successful ectopic replacement and improved outcomes.
Abstract

Keywords:
Cathetersdialysisdialysis accessintensive caretechniques and procedures

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