title: Effectiveness of sutureless percutaneous placement of cuffed tunneled hemodialysis catheters applying StatLock attachment devices.
abstract: OBJECTIVE
  A prospective, randomized-controlled trail was conducted to evaluate the effectiveness of securing tunneled hemodialysis (HD) catheters with sutureless StatLock attachment devices (Bard Access Systems) compared to traditional suture fixation.
  
  
  METHODS
  At a university teaching hospital 72 patients with chronic renal failure received cuffed tunneled HD catheters. In the study group (n=36) the HD catheters were secured with a sutureless StatLock attachment device, whereas the control group HD catheters were fixated with sutures only. The intended intermediate use of the tunneled HD catheters was 42 ± 7 days until the arteriovenous fistula was sufficient. All catheters were placed by an interventional radiologist using ultrasound for the puncture of the internal jugular vein. We evaluated the success and complication rate of tunneled catheter implantation.
  
  
  RESULTS
  The primary success rate for implantation of HD catheters was 100%. There was an overall complication rate of 8.3% in the study group (one hematoma in the subcutaneous catheter tract and two central venous thromboses). In the control group the overall complication rate was 13.9% (two hematomas, one central venous thrombosis and two catheter displacements). The two catheter displacements required a HD catheter exchange. In addition, four local irritations at the HD catheter entry site were seen only in the control group and were rated as minor complications.
  
  
  CONCLUSIONS
  The sutureless placement technique is safe and effective with a low complication rate, and is superior to the traditional suture fixation of tunneled catheters.
authors.affiliation: Department of Radiology, Charité University Medicine, Berlin, Germany. ulf.teichgraeber@charite.de
authors.forename: Ulf Karl-Martin
authors.initials: UK
authors.lastname: Teichgräber
authors.forename: Maximilian
authors.initials: M
authors.lastname: de Bucourt
authors.forename: Bernhard
authors.initials: B
authors.lastname: Gebauer
authors.forename: Florian
authors.initials: F
authors.lastname: Streitparth
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.forename: Christian
authors.initials: C
authors.lastname: Enzweiler
mesh_terms: D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects; D020878:Device Removal; D004867:Equipment Design; D005260:Female; D006406:Hematoma / Q000209:etiology; D006784:Hospitals, Teaching; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D056824:Upper Extremity Deep Vein Thrombosis / Q000209:etiology