Related Experiment Video

Updated: Sep 7, 2025

Laparoscopic-Assisted Seldinger Technique for Peritoneal Dialysis Catheter Insertion
06:23

Laparoscopic-Assisted Seldinger Technique for Peritoneal Dialysis Catheter Insertion

Published on: May 23, 2025

453

Deeper may not be better: relationship between catheter dysfunction and location of the catheter tip in right-sided

N Y T Soh1, B S Tan1, S J M Chan1

  • 1Department of Vascular and Interventional Radiology, Singapore General Hospital, Singapore.

Clinical Radiology
|June 18, 2022
PubMed

Insights

Optimal placement of tunnelled central venous catheters (CVCs) in the superior vena cava (SVC) reduces catheter dysfunction in haemodialysis patients. This finding is crucial for improving CVC longevity and patient outcomes.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Radiology

Background:

  • Tunnelled central venous catheters (CVCs) are essential for haemodialysis access.
  • Catheter dysfunction is a common complication, impacting treatment efficacy.
  • Optimal catheter tip positioning is hypothesized to influence CVC function.

Purpose of the Study:

  • To investigate the association between the tip location of tunnelled CVCs and the incidence of catheter dysfunction.
  • To identify ideal catheter tip placement for reducing complications in haemodialysis patients.

Main Methods:

  • Retrospective analysis of 993 haemodialysis patients with tunnelled CVCs (step-tip design) inserted via the right internal jugular vein.
  • Categorization of catheter tip position into superior vena cava (SVC), cavo-atrial junction (CAJ), or deep right atrium (DRA) using intra-procedural radiographs.
  • Tracking of patients for 90 days post-insertion to record complications requiring catheter replacement.

Main Results:

  • Catheter dysfunction necessitating replacement occurred in 9.6% of patients within 90 days.
  • SVC tip location was associated with significantly lower dysfunction rates (1.9%) compared to CAJ (8%) and DRA (11%; p=0.049).
  • No significant relationship was found between tip location and other complications like infection or dislodgement.

Conclusions:

  • Positioning the catheter tip in the SVC is linked to a reduced risk of dysfunction for tunnelled CVCs with a step-tip design.
  • This finding supports SVC as the preferred location to minimize catheter-related issues in haemodialysis patients.
Abstract

More Related Videos

A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice06:27

A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice

Published on: July 20, 2022

2.7K
Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device07:41

Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device

Published on: July 20, 2022

2.0K

Related Concept Videos

Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
279
Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
149
Cardiac Catheterization II: Right Heart Catheterization01:21

Cardiac Catheterization II: Right Heart Catheterization

Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
158
Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
126
Cardiac Catheterization III: Left Heart Catheterization01:24

Cardiac Catheterization III: Left Heart Catheterization

Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
203
Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
186