title: Outcomes and performance of the Tesio twin catheter system placed for hemodialysis access.
abstract: OBJECTIVE
  To assess the effectiveness of and outcomes with a twin catheter system.
  
  
  METHODS
  The authors retrospectively reviewed the medical records, hemodialysis records, and clinical information system data from 132 consecutive patients who were referred for placement of a tunneled catheter for hemodialysis access. A commercially available twin catheter system was placed in all patients. Outcomes evaluated included infection rate, complication rate, and catheter malfunction and failure rates. Performance parameters evaluated included blood flow rates, urea reduction percentages, and recirculation percentages.
  
  
  RESULTS
  One hundred eighty-four twin catheter systems were placed in 132 patients from January 11, 1996, to October 23, 1997. The initial technical success rate was 100%. There were four immediate procedural complications: Air emboli occurred in two patients, and prolonged bleeding necessitating intervention occurred in two. The total number of days a catheter was in place was 13,200 (mean, 74.6 days). Thirty-one infections occurred in 20 patients (total infection rate, 0.23 episodes per 100 catheter days). Sixty-five catheters malfunctioned during the study period, 19 of which necessitated removal, for a rate of 0.14 episodes per 100 catheter days. The average blood flow rate was 281.4 mL/min (range, 117.1-405.6 mL/min; median, 295.2 mL/min). Mean and median urea reductions were both 61%. Mean and median recirculation was 6.1% and 3.5%, respectively (range, 0%-31%).
  
  
  CONCLUSIONS
  Percutaneous placement of the tunneled twin catheter system can be performed with excellent technical success and safety and acceptable catheter performance and outcomes for effective intermediate- to long-term hemodialysis.
authors.affiliation: Department of Radiology, Dartmouth-Hitchcock Medical Center, One Medical Center Dr, Lebanon, NH 03756, USA.
authors.forename: W
authors.initials: W
authors.lastname: Wivell
authors.forename: M A
authors.initials: MA
authors.lastname: Bettmann
authors.forename: B
authors.initials: B
authors.lastname: Baxter
authors.forename: D R
authors.initials: DR
authors.lastname: Langdon
authors.forename: B
authors.initials: B
authors.lastname: Remilliard
authors.forename: M
authors.initials: M
authors.lastname: Chobanian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D020878:Device Removal; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D006435:Renal Dialysis; D012189:Retrospective Studies