title: Long-term performance and complications of the Tesio twin catheter system for hemodialysis access.
abstract: The Tesio twin catheter system (Medcomp, Harleysville, PA) was developed to overcome the problems with the existing central venous catheters in providing high-efficiency dialysis, such as inadequate blood flows, high recirculation rates, and need for surgical insertion. The relatively large internal lumens and multiple side holes in a spiral pattern allow for high blood flow rates and lower tendency to thrombosis. In this series, 82 catheter pairs were placed in 75 patients and monitored for a period encompassing 231 patient-months. We achieved mean nominal blood pump flow rates of 400 +/- 6 mL/min and an average recirculation of 4.6% +/- 0.5%. In 20 sets of catheters, a nominal blood flow rate of 388 +/- 6 mL/min was measured ultrasonically at 352 +/- 8 mL/min, representing an error of 36 +/- 5 mL/min. Thrombosis of the catheter occurred at a rate of one episode per 21 patient-months, and on all occasions responded to local instillation of urokinase. Despite having two exit sites, the infection rates were comparable to other catheters: exit site infections occurred at a rate of one per 21 patient-months and bacteremic episodes occurred at one per 11.5 patient-months, necessitating catheter removal once per 46 patient-months. Based on these data, we believe that the Tesio twin catheter system is an excellent long- and short-term vascular access for providing high-efficiency dialysis.
authors.affiliation: Department of Medicine, University of Florida, Gainesville 32610-0224, USA.
authors.forename: P N
authors.initials: PN
authors.lastname: Prabhu
authors.forename: S R
authors.initials: SR
authors.lastname: Kerns
authors.forename: F W
authors.initials: FW
authors.lastname: Sabatelli
authors.forename: I F
authors.initials: IF
authors.lastname: Hawkins
authors.forename: E A
authors.initials: EA
authors.lastname: Ross
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy; D016470:Bacteremia / Q000209:etiology; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007601:Jugular Veins; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation*; D012189:Retrospective Studies; D013927:Thrombosis / Q000209:etiology