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Double catheterization of the internal jugular vein for hemodialysis: indications, techniques, and clinical results
F Tesio1, H De Baz, G Panarello
1Servizio di Nefrologia e Dialisi, Civil Hospital, Pordenone, Italy.
Insights
This study shows that using a two-catheter system inserted via the internal jugular vein is a safe and effective method for long-term hemodialysis access in uremic patients, with good survival rates and manageable complications.
Area of Science:
- Nephrology
- Vascular Surgery
- Medical Devices
Background:
- Central vascular catheters are essential for hemodialysis in patients with kidney failure.
- Internal jugular vein access is often preferred due to a lower risk of adverse events compared to other sites.
- Long-term data on specific catheter systems are crucial for clinical decision-making.
Purpose of the Study:
- To evaluate the long-term safety and efficacy of a two-catheter system for hemodialysis access.
- To assess survival rates and complication profiles associated with internal jugular vein cannulation.
Main Methods:
- A retrospective study involving 108 patients undergoing hemodialysis.
- Percutaneous cannulation of the internal jugular vein using Medcomp silicone rubber catheters.
- Analysis of patient survival, blood flow rates, venous pressures, and complication incidence.
Main Results:
- One- and 2-year survival rates were 93% and 91%, respectively.
- Average blood flow rate was 284 mL/min, with venous pressure at 1 year at 90 mm Hg.
- Key complications included catheter clotting (11), sepsis (7), and accidental withdrawal (6).
Conclusions:
- The described two-catheter system via the internal jugular vein offers a safe and reliable option for long-term hemodialysis.
- The system demonstrates good long-term patient survival and a low rate of serious complications.
- This approach supports effective vascular access for chronic hemodialysis patients.
Abstract:
Central vascular catheters are used to access the central vascular system in both acute and chronic uremic patients undergoing hemodialysis. Among different approaches, the internal jugular vein seems to have less adverse effects. We describe our long-term experience with a two-catheter system. Percutaneous jugular vein cannulation was performed using Medcomp silicone rubber catheters. The study included 108 patients undergoing hemodialysis. One- and 2-year survival was 93 and 91%, respectively; 36 died because of unrelated causes. Blood flow rate was 284 mL/min; venous pressure at 1 year was 90 mm Hg. Complications included accidental withdrawal (6), dysfunction (4), catheter clotting (11), mediastinal hematoma (2), pneumothorax (1), and sepsis (7). Good long-term survival and a low complication rate make this system a safe and reliable method of access for long-term hemodialysis.