Efficacy and safety results with the LifeSite hemodialysis access system versus the Tesio-Cath hemodialysis catheter at 12 months.
OBJECTIVE
To compare the performance and safety of a fully subcutaneous vascular access device, the LifeSite hemodialysis access system, versus a tunneled hemodialysis catheter, the Tesio-Cath, at 1 year after implantation.


METHODS
Sixty-eight patients who required hemodialysis received implantation of the LifeSite device or a Tesio-Cath device as a part of this multicenter study. Thirty-four patients were treated in each group. The endpoints observed included blood flow rates and associated venous pressures, overall and device-related adverse events, the need for thrombolytic infusions, device-related infections (DRIs) and associated hospitalizations, and technical device survival.


RESULTS
During the 12-month observation period, significantly higher venous pressures were required in patients with the Tesio-Cath to achieve blood flow rates comparable with those achieved with the LifeSite device. Patients in the LifeSite group experienced a significantly lower rate of non-device-related adverse events (P < .001), device-related adverse events (P < .016), need for thrombolytic infusions (P < .002), and DRIs (P < .013) compared with patients in the Tesio-Cath group. There was a trend toward a lower number of hospital days per month for DRIs in the LifeSite group, with the rate for the Tesio-Cath group being twice that in the LifeSite group. The use of the LifeSite device was also associated with a significantly higher probability of device survival for 12 months after censoring for planned removals (P < .031).


CONCLUSIONS
The results of the present study demonstrate superior device performance and technical device survival, reduced complications, and the need for fewer interventions with the LifeSite hemodialysis access system compared with a standard hemodialysis catheter during a 1-year time period after implantation.
Yale University, New Haven, Connecticut, USA.
Melvin
M
Rosenblatt
James G
JG
Caridi
Faris Z
FZ
Hakki
Jerry
J
Jackson
Toros
T
Kapoian
Samuel P
SP
Martin
John
J
Moran
Alexander
A
Pedan
Woody J
WJ
Reese
John P
JP
Ross
Jamie
J
Ross
Fred
F
Rushton
Steven J
SJ
Schwab
Ramesh
R
Soundararajan
Brian
B
Stainken
Mark A
MA
Weiss
Jack
J
Work
James
J
Yegge
D000890:Anti-Infective Agents / Q000008:administration & dosage; D001424:Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control; D001557:Benzenesulfonates / Q000008:administration & dosage; D002408:Catheters, Indwelling / Q000009:adverse effects; D004869:Equipment Safety; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis / Q000295:instrumentation*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D001557:Benzenesulfonates; C018120:oxychlorosene