title: Tesio catheter access for long-term maintenance hemodialysis.
abstract: OBJECTIVE
  To retrospectively determine the long-term outcome (>6 months) of placement of tunneled hemodialysis catheters.
  
  
  METHODS
  The HIPAA-compliant study protocol was approved by the Committee on Human Research, which waived the requirement for informed consent. The records of patients who underwent hemodialysis with the Tesio system (Medcomp, Harleysville, Pa) at a single outpatient dialysis unit between March 1994 and March 2004 were reviewed. The length of catheter access and the requirements for percutaneous revision were recorded, and unassisted- and assisted-access survival times were computed by using the Kaplan-Meier method.
  
  
  RESULTS
  Three hundred three primary Tesio accesses were created in 200 patients (mean age, 62.3 years +/- 16.3 [standard deviation]; 102 women [51.0%]). Fifty-nine of 303 accesses (19.5%) were percutaneously revised with catheter exchange. During follow-up, 200 of 303 accesses (66.0%) were terminated (117 because they were no longer needed and 83 because of catheter malfunction), and 103 (34.0%) accesses were functioning at the time of last follow-up. The mean duration of catheter access was 247 days (range, 3-2016 days). One hundred twenty-six (41.6%) accesses remained in use for more than 6 months; 50 (16.5%), for more than 1 year; 20 (6.6%), for more than 2 years; 14 (4.6%), for more than 3 years; and five (1.7%), for more than 4 years. Assisted-access survival was 78.1%, 60.0%, 51.5%, 51.5%, and 46.8% at 6 months and 1, 2, 3, and 4 years, respectively.
  
  
  CONCLUSIONS
  Tesio catheters frequently function for periods longer than 6 months and, when necessary, they can function for many years.
authors.affiliation: Department of Radiology, University of California, San Francisco, Box 0628, 505 Parnassus Ave, San Francisco, CA 94143-0628, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Wang
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: LaBerge
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Chertow
authors.forename: Robert K
authors.initials: RK
authors.lastname: Kerlan
authors.forename: Mark W
authors.initials: MW
authors.lastname: Wilson
authors.forename: Roy L
authors.initials: RL
authors.lastname: Gordon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization; D002408:Catheters, Indwelling / Q000009:adverse effects; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome