A randomized, prospective evaluation of the Tesio, Ash split, and Opti-flow hemodialysis catheters.
OBJECTIVE
A randomized, prospective evaluation of three high-flow hemodialysis catheters.


METHODS
Ninety-four patients were randomly assigned 113 Tesio, Ash split, and Opti-flow catheters from December 1998 through June 1999. Insertion times, procedural complications, and ease of insertion were recorded. Mean catheter flow rates were recorded at first dialysis, 30 days, and 90 days. Patency, catheter survival, and catheter-related infections were evaluated.


RESULTS
Thirty-eight Ash split, 39 Opti-flow, and 36 Tesio catheters were placed. Tesio mean insertion time (41.5 min) was significantly longer than Ash split (29.4 min) or Opti-flow (29.6 min) (P =.004). There were four complications related to Tesio catheters (three cases of pericatheter bleeding, one air embolism), one related to an Opti-flow catheter (pericatheter bleeding), and zero related to Ash split catheters. Opti-flow and Ash split catheters were significantly easier to insert than Tesio catheters (P =.041). Mean flow rates were not significantly different among the catheters initially (P =.112), at 30 days (P =.281), or at 90 days (P =.112). Catheter-related infection rates per 100 catheter days were 0.12 for Ash split, 0.35 for Opti-flow, and 0.14 for TESIO: Median catheter survival was 302 days for Ash split, 176 days for Opti-flow, and 228 days for TESIO:


CONCLUSIONS
Opti-Flow and Ash split catheters were faster and easier to place than Tesio catheters. There was no difference in hemodialysis flow rates or catheter survival.
Richard
H M
HM
Department of Diagnostic Imaging, Division of Interventional Radiology, University of Maryland Medical Systems, Baltimore, MD, USA. howard.richard@umm.edu
Hastings
G S
GS
Boyd-Kranis
R L
RL
Murthy
R
R
Radack
D M
DM
Santilli
J G
JG
Ostergaard
C
C
Coldwell
D M
DM
D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D016009:Chi-Square Distribution; D004867:Equipment Design; D005260:Female; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D006435:Renal Dialysis / Q000295:instrumentation*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014654:Vascular Patency