title: Do AshSplit haemodialysis catheters provide better flow rates in the long term?
abstract: BACKGROUND
  Recently, interventional radiologists have adopted an increasingly prominent role in the placement and management of hemodialysis catheters, as well as in the research and development of new and better catheters. The purpose of this study was to evaluate the viability and hemodialysis efficiency of the AshSplit catheter and the Permcath catheter.
  
  
  METHODS
  204 consecutive patients requiring radiological insertion of hemodialysis catheters were followed, retrospectively, over a 42-month period. Both hemodialysis catheters were placed using a combination of ultrasonic and fluoroscopic guidance and tunneled appropriately. Information collected included catheter insertion sites, insertion complications, catheter duration, and final outcome.
  
  
  RESULTS
  Over the study period of two years, 269 catheters were placed into 204 patients with end stage renal failure. Patients received either an AshSplit (101 patients, 127 catheters) or a Permcath (103 patients, 142 catheters). Vascular access route of choice was the right internal jugular vein (67% AshSplit, 71% Permcath). Insertion complications occurred in 18 patients overall (6.6%), with only 1 requiring further intervention (hemopneumothorax). Flow rates averaged 259 mls/min for AshSplits and 248 mls/min for Permcaths (p < 0.001). Follow-up of catheter viability for 42 months yielded a mean AshSplit catheter duration of 246 days (range 6-932) and 239 days (range 1-1,278) for Permcath (p = 0.46). Reasons for catheter failure and elective catheter removal were similar in both groups; however, Permcaths required significantly more thrombolysis than AshSplits, p < 0.001.
  
  
  CONCLUSIONS
  The AshSplit provides significantly better flow rates and less thrombolysis compared to the Permcath, with similar catheter dwell times.
authors.affiliation: Department of Academic Radiology, Beaumont Hospital, Beaumont Road, Dublin, Ireland.
authors.forename: A N
authors.initials: AN
authors.lastname: Keeling
authors.forename: H
authors.initials: H
authors.lastname: O'Dwyer
authors.forename: S
authors.initials: S
authors.lastname: Lyon
authors.forename: P
authors.initials: P
authors.lastname: O'Kelly
authors.forename: F P
authors.initials: FP
authors.lastname: McGrath
authors.forename: P J
authors.initials: PJ
authors.lastname: Conlon
authors.forename: M J
authors.initials: MJ
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000295:instrumentation; D002408:Catheters, Indwelling; D020878:Device Removal; D005040:Ethynodiol Diacetate; D005260:Female; D006801:Humans; D007601:Jugular Veins; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D006435:Renal Dialysis; D016019:Survival Analysis
chemical_list: D005040:Ethynodiol Diacetate