Subcutaneous anchoring device for securement of tunneled hemodialysis catheters: A first retrospective multicenter...

Subcutaneous Anchor Securement System (SASS) are increasingly used for stabilization of vascular access devices. For many hemodialysis (HD) patients tunneled central venous catheters (t-CVC) are the last vascular access option and their unplanned replacement results in complex procedures and increased costs. Nevertheless, accidental dislodgment of hemodialysis t-CVC is a frequent occurrence in clinical practice. We here describe our first experience with SASS utilization in this unexplored setting.

Between July 2022 and September 2023, we applied a SASS (SecurAcath^®) to newly placed Tesio t-CVC in two HD centers. Patients were routinely monitored as per center standard protocol for accidental t-CVC dislodgment, tip migration, t-CVC dysfunction, early and late SASS-related complications, until a censoring event or the end of follow-up (December 2023) occurred. Data were retrospectively collected by two Authors per center, cross-checked, and analyzed with descriptive statistics in a case series.

Twenty-four Tesio t-CVC were included in the analysis. Among the entire cohort, the SASS (each with the corresponding t-CVC) were maintained for a total of 5.324 CVC-days. Median single device length of follow-up was 188 (144-276) days. Complete accidental dislodgment with cuff exposure and need for t-CVC replacement was never observed. One bleeding episode was reported among early complications. Infection incidence rate was 0.56 per 1.000 CVC-days and 71% of Tesio t-CVC with their SASS were still in use at the end of follow-up.

This is the first report of the use of SASS in HD t-CVC. In our experience, SecurAcath^® was safe and effective for stabilization of Tesio t-CVC.