Tunneled femoral dialysis catheter: Practical pointers

Area of Science:

• Nephrology
• Vascular Surgery
• Interventional Radiology

Background:

• Achieving adequate long-term bloodstream access for hemodialysis (HD) is crucial for end-stage kidney disease (ESKD) management.
• Upper extremity arteriovenous fistulas are preferred but can fail due to complications like stenosis or thrombosis.
• Lower extremity vascular access becomes necessary when upper extremity options are exhausted.

Approach:

• This review synthesizes current literature on tunneled femoral dialysis catheter placement.
• It focuses on indications, contraindications, and practical procedural tips for successful catheter insertion.
• The review also addresses and clarifies prevalent misconceptions surrounding femoral catheter practices.

Key Points:

• Femoral catheterization is a viable option for hemodialysis vascular access when other sites are unavailable.
• Understanding specific indications and contraindications is essential for patient selection.
• Mastering procedural techniques and dispelling myths improves patient outcomes and access longevity.

Conclusions:

• Tunneled femoral dialysis catheters provide an essential alternative vascular access for hemodialysis patients.
• Successful placement relies on careful patient selection, adherence to procedural guidelines, and addressing common misconceptions.
• Optimizing femoral catheter use can improve the quality of life for patients with end-stage kidney disease.