title: Tesio catheter: radiologically guided placement, mechanical performance, and adequacy of delivered dialysis.
abstract: OBJECTIVE
  Tunneled catheters are an alternative means of vascular access for patients in need of hemodialysis who cannot undergo dialysis through a surgical shunt. This study was undertaken to evaluate the performance of the Tesio dialysis catheter.
  
  
  METHODS
  A prospective study of the Tesio catheter was performed. Follow-up data regarding catheter function and adequacy of dialysis were obtained from nine hemodialysis facilities.
  
  
  RESULTS
  Seventy-nine Tesio catheters were placed in 71 patients. Immediate technical success was 99% (78 of 79 catheters). The procedure complication rate was 9% (seven catheters). Only two complications required intervention: one fatal air embolism and one chest wall hematoma. Sixty-seven catheters in 60 patients were followed up for a total of 4,367 catheter days. Overall, catheter-related infection occurred in 9% (six of 67 catheters). Primary catheter patency was 87% at 1 week, 82% at 1 month, 72% at 3 months, and 66% at 6 months. Mean blood flow was 286 mL/min immediately after insertion, 301 mL/min at 3 months, and 306 mL/min at 6 months. Adequate dialysis dose as reflected by a urea reduction ratio of 60 or more or a urea kinetic modeling, or Kt/V, value of 1.2 or more was observed on at least one occasion for 74% and 76% of catheters, respectively.
  
  
  CONCLUSIONS
  The Tesio catheter is a reasonable means of vascular access for patients who undergo dialysis but are not candidates for surgical shunt placement.
authors.affiliation: Departments of Radiology, University of California San Francisco, Box 0628, 505 Parnassus Ave, San Francisco, CA 94143-0628, USA. perini@ itsa.ucsf.edu
authors.forename: S
authors.initials: S
authors.lastname: Perini
authors.forename: J M
authors.initials: JM
authors.lastname: LaBerge
authors.forename: J M
authors.initials: JM
authors.lastname: Pearl
authors.forename: H L
authors.initials: HL
authors.lastname: Santiestiban
authors.forename: H E
authors.initials: HE
authors.lastname: Ives
authors.forename: R S
authors.initials: RS
authors.lastname: Omachi
authors.forename: M
authors.initials: M
authors.lastname: Graber
authors.forename: M W
authors.initials: MW
authors.lastname: Wilson
authors.forename: S R
authors.initials: SR
authors.lastname: Marder
authors.forename: B R
authors.initials: BR
authors.lastname: Don
authors.forename: R K
authors.initials: RK
authors.lastname: Kerlan
authors.forename: R L
authors.initials: RL
authors.lastname: Gordon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections; D001783:Blood Flow Velocity / Q000502:physiology; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000145:classification / Q000382:microbiology; D002648:Child; D004618:Embolism, Air / Q000209:etiology; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation*; D013223:Statistics as Topic; D013896:Thoracic Diseases / Q000209:etiology; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014508:Urea / Q000097:blood
chemical_list: D014508:Urea