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Related Experiment Videos

Polyurethane catheters for long-term hemodialysis access

D J Hirsch1, P Bergen, K K Jindal

  • 1Division of Nephrology, Dalhousie University, Halifax, Nova Scotia, Canada.

Artificial Organs
|May 1, 1997
PubMed
Summary

This study shows that polyurethane central venous catheters are a successful alternative for long-term hemodialysis in patients with failed arteriovenous access. This method offers a viable vascular access option, reducing complications and the need for invasive procedures.

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Area of Science:

  • Nephrology
  • Vascular Access
  • Dialysis

Background:

  • Chronic hemodialysis patients often experience failure of native fistulas and synthetic grafts, necessitating alternative vascular access.
  • Surgically placed silicone jugular catheters are a common, but sometimes problematic, solution.

Purpose of the Study:

  • To evaluate the efficacy and safety of percutaneously placed double lumen polyurethane central venous catheters for long-term hemodialysis in patients with exhausted traditional access options.
  • To assess outcomes including duration of use, complication rates, and patient survival.

Main Methods:

  • Percutaneous placement of double lumen polyurethane central venous catheters in 11 long-term hemodialysis patients with a history of failed arteriovenous access.
  • Catheter replacement over a guidewire at the bedside for poor flow.

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  • Monitoring of dialysis adequacy (urea reduction), septicemia, central venous occlusion, and patient survival.

    • Main Results:

    • Polyurethane catheters provided vascular access for a mean of 681 days.
    • Mean urea reduction was 64.2%, indicating effective dialysis.
    • Septicemia rate was low (1.2 episodes/1000 catheter-days), but central venous occlusion occurred in 20% of patients, primarily with subclavian placement.

    Conclusions:

    • Percutaneous polyurethane central venous catheters represent a successful and acceptable form of long-term vascular access for hemodialysis patients with complex access issues.
    • Jugular placement may reduce the incidence of central venous occlusion compared to subclavian placement.
    • This technique avoids the need for urokinase, radiologic interventions, and surgical placement, simplifying patient management.