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[Temporary vascular access: from peripheral to central, from temporary to permanent]

B Canaud1, H Leray, J J Béraud

  • 1Service de Néphrologie-Soins intensifs, Hôpital Lapeyronie, Montpellier.

Nephrologie
|January 1, 1994
PubMed
Summary

Temporary vascular access (TVA) has shifted to central venous catheters for hemodialysis. This change simplifies management for end-stage renal disease (ESRD) patients, improving dialysis efficiency.

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Area of Science:

  • Nephrology
  • Vascular Access
  • Dialysis

Background:

  • Temporary vascular access (TVA) is crucial for hemodialysis in end-stage renal disease (ESRD) patients.
  • Trends show a shift from peripheral to central and temporary to permanent access methods.
  • The subclavian approach has been largely abandoned due to mechanical risks.

Purpose of the Study:

  • To illustrate changes in temporary vascular access over the past decade.
  • To compare the efficacy and complications of different central venous catheter placements.
  • To highlight the increasing reliance on percutaneous central venous catheters for hemodialysis.

Main Methods:

  • Retrospective analysis of temporary vascular access methods used over ten years.
  • Comparison of short-term (femoral vein) and long-term (internal jugular vein) central venous catheters.

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  • Evaluation of dialysis performance metrics including blood flow rate and recirculation rate.

    • Main Results:

    • Peripheral arteriovenous shunts have been replaced by central venous catheters.
    • Femoral catheters (short-term) showed mechanical complications; jugular catheters (long-term) were associated with infection.
    • Achieved blood flow rates of 250-350 ml/min and recirculation rates of 9-12% in approximately 1500 patients.

    Conclusions:

    • Temporary vascular access is now predominantly achieved via percutaneous central venous catheters.
    • This shift has simplified physician tasks and improved management of large-scale dialysis programs.
    • Central venous catheters offer efficient hemodialysis, though complication profiles vary by insertion site and duration.