title: Insertion of tunneled hemodialysis catheters without fluoroscopy.
abstract: BACKGROUND
  The tunneled cuffed catheter (TCC) is used as a bridge access for hemodialysis. Few prospective studies have been designed to evaluate conversion from non-tunneled to TCC without the use of fluoroscopy when performed by nephrologists.
  
  
  METHODS
  We performed an observational prospective cohort in incident patients receiving hemodialysis through a non-tunneled right jugular vein catheter.
  
  
  RESULTS
  130 procedures were performed in 122 patients (51+/-18 years). The success rate was 100%. There was a total of 26,546 catheter days. Ninety-one of the 130 catheters were removed during the study period. Life table analysis revealed primary patency rates of 92%, 82%, and 68% at 30, 60, and 120 days, respectively. Infection requiring catheter removal occurred at a frequency of 0.09 per 100 catheter days. Catheter malfunction requiring intervention occurred at a rate of 0.03 per 100 catheter days. Hypertension and duration of existing non-tunneled catheter of less than 2 weeks were independently associated with better TCC survival.
  
  
  CONCLUSIONS
  The conversion from non-tunneled to TCC performed by nephrologists and without fluoroscopy may be safe by using the internal right jugular vein. The ideal time to do this procedure is within less than 2 weeks of existing non-tunneled catheter.
authors.affiliation: Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil. rosilenemotta@hotmail.com
authors.forename: Rosilene
authors.initials: R
authors.lastname: Motta Elias
authors.forename: Sonia Cristina
authors.initials: SC
authors.lastname: da Silva Makida
authors.forename: Hugo
authors.initials: H
authors.lastname: Abensur
authors.forename: Manuel Carlos
authors.initials: MC
authors.lastname: Martins Castro
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Affonso Moysés
authors.forename: Benedito Jorge
authors.initials: BJ
authors.lastname: Pereira
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Bueno de Oliveira
authors.forename: Cláudio
authors.initials: C
authors.lastname: Luders
authors.forename: João Egidio
authors.initials: JE
authors.lastname: Romão
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D055499:Catheter-Related Infections / Q000209:etiology; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D002408:Catheters, Indwelling / Q000009:adverse effects; D020878:Device Removal; D004868:Equipment Failure; D005471:Fluoroscopy; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging; D053208:Kaplan-Meier Estimate; D015993:Life Tables; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015641:Radiography, Interventional; D006435:Renal Dialysis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult