Insertion of tunneled hemodialysis catheters without fluoroscopy.
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.
Motta Elias
Rosilene
R
Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil. rosilenemotta@hotmail.com
da Silva Makida
Sonia Cristina
SC
Abensur
Hugo
H
Martins Castro
Manuel Carlos
MC
Affonso Moysés
Rosa Maria
RM
Pereira
Benedito Jorge
BJ
Bueno de Oliveira
Rodrigo
R
Luders
Cláudio
C
Romão
João Egidio
JE
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