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Outcome of tunneled hemodialysis catheters placed by radiologists
G B Lund1, S O Trerotola, P F Scheel
1Russell Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
Purpose:
To compare the outcomes of hemodialysis catheters placed by interventional radiologists with those placed by surgeons.
Materials And Methods:
The outcomes were retrospectively analyzed of 237 hemodialysis catheters placed in 140 patients by a radiology service from January 1991 through December 1992. Follow-up data were available for 222 catheters (94%). Catheter secondary patency and freedom from infection were analyzed statistically and by means of life-table analysis.
Results:
Pneumothorax occurred after the placement of six catheters (2.5%); in two patients, a chest tube was required for decompression. Other short-term complications included air embolism with no clinical sequelae (two procedures) and prolonged oozing from the tunnel (two procedures). Long-term complications included infection and catheter failure. Infection occurred in 26 patients (18%) with 32 catheters (14%) and resulted in removal of 25 catheters. Ninety-three catheters (42%) failed, and 63 catheters (28%) were removed because of failure.
Conclusion:
Hemodialysis catheters placed by radiologists do not have a higher rate of complications or failure than catheters placed by surgeons.