Long-term Tesio catheter access for hemodialysis can deliver high dialysis adequacy with low complication rates

Albert Power, Seema K Singh, Damien Ashby, Tom Cairns, David Taube, Neill Duncan

Research output: Contribution to journalArticle (Academic Journal)peer-review

11 Citations (Scopus)

Abstract

PURPOSE: The use of central venous catheters for long-term hemodialysis has been associated with increased mortality and high prevalence of infection and venous stenosis. However, because central venous catheters still constitute a significant proportion of vascular access in prevalent populations, even in the Fistula-First era, the authors examined the long-term patient outcomes and performance of this vascular access type to inform current clinical practice.

MATERIALS AND METHODS: The authors conducted a retrospective cohort study of 433 patients on maintenance hemodialysis in a dialysis program from January 1999 through April 2008 all using twin-catheter Tesio Caths (TCs) (MedCOMP, Harleysville, Pennsylvania). Written and electronic records were examined with respect to laboratory indices as well as mortality, access-related infection, need for thrombolytic infusion, access revision and dialysis adequacy.

RESULTS: A total of 759 TCs were inserted with 552,035 catheter days follow-up. Thirty-six percent of insertions were in patients incident to dialysis (< 90 days). Mean single-pool Kt/V was 1.6 ± 0.3. Cumulative cohort survival rates were 85%, 72%, and 48% at 1, 2, and 5 years, respectively. No patients died as a result of lack of vascular access. Cumulative assisted primary access site patencies were 76%, 62%, and 42% at 1, 2, and 5 years, respectively. The prevalence of symptomatic central venous stenosis was 5%. Catheter-related bacteremia occurred at a rate of 0.34 per 1,000 catheter days.

CONCLUSIONS: Appropriate use of TCs with protocolized care can deliver effective long-term hemodialysis with good adequacy and rates of access-related infection approaching those seen with arteriovenous grafts.

Original languageEnglish
Pages (from-to)631-7
Number of pages7
JournalJournal of Vascular and Interventional Radiology
Volume22
Issue number5
DOIs
Publication statusPublished - May 2011

Bibliographical note

Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

Keywords

  • Adult
  • Aged
  • Anti-Bacterial Agents
  • Catheter-Related Infections
  • Catheterization, Central Venous
  • Catheters, Indwelling
  • Equipment Design
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • London
  • Male
  • Middle Aged
  • Renal Dialysis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Survival Rate
  • Thrombolytic Therapy
  • Time Factors
  • Treatment Outcome
  • Vascular Patency
  • Venous Thrombosis

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