[Tunneled double femoral catheters: emergency vascular access for hemodialysis]

Transient vascular access for hemodialysis is a daily problem in nephrology. Internal jugular twin catheters using Canaud's technique is the method of reference, which we have applied since 1987. In 3 cases where the internal jugular route was impraticable, twin catheters via the femoral route were used. The catheter was placed by percutaneous route, at the bedside, in rigorous aseptic conditions and with local anesthesia. The catheter emerge at mid-thigh. Mean placement time was 45 mn. The ideal site for distal end of the catheters is in the inferior vena cava. No traumatic complication occurred during placement. No infectious episode was observed. All the catheters that were removed were sterile in culture. No thrombosis of femoral, iliac or inferior cava veins were observed by echodoppler after removal of the catheters. In conclusion, twin femoral catheters are a good alternative when jugular access is impossible or contraindicated.