Successful use of indwelling cuffed femoral vein catheters in ambulatory hemodialysis patients.
Three hemodialysis patients with multiple upper extremity vascular access complications and central vein stenosis were treated for as long as 3 months using an indwelling femoral vein catheter having a buried felt cuff in its subcutaneous tunnel. Four catheters were placed in these three patients. In one case, initial failure due to poor flow and clotting occurred using a straight catheter with its tunnel crossing the inguinal ligament and exiting caudally on the anterior thigh. Otherwise, each patient had successful placement of a 180-degree, curved catheter that exited the femoral vein in the usual fashion but had a subcutaneous tunnel and skin exit pointing cephalad in the inferior portion of the right lower quadrant. The three successful devices functioned immediately after placement, having acceptable outflow pressures and recirculation values. One of three catheters was removed 3 weeks after placement when persisting infection was thought to reside on the device. No other bleeding, thromboembolic, or infectious complications occurred in these patients. In conclusion, short-term indwelling femoral vein access may be feasible in ambulatory hemodialysis patients with previous access difficulties that complicate temporary dialysis treatment.
Weitzel
W F
WF
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0364.
Boyer
C J
CJ
el-Khatib
M T
MT
Swartz
R D
RD
D000328:Adult; D002408:Catheters, Indwelling; D005268:Femoral Vein; D006437:Hemodialysis, Home / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged