title: Self-centering split-tip catheter versus conventional split-tip catheter in prevalent hemodialysis patients.
abstract: OBJECTIVE
  This study compared the patency of a split-tip self-centering catheter with a predesigned curve (CentrosFLO; Merit, Salt Lake City, Utah) and a standard split-tip catheter with straight distal limbs (Medcomp, Harleysville, Pennsylvania) catheter in patients requiring exchange of a dysfunctional tunneled dialysis catheter (TDC).
  
  
  METHODS
  A single-center retrospective chart review was performed between January 2013 and July 2014. Patients had an existing dysfunctional TDC that was exchanged over a wire using the same access site for either a split-tip self-centering catheter with a predesigned curve or a standard split-tip catheter with straight distal limbs catheter. The primary endpoint was catheter patency analyzed at 1, 3, and 6 months after initial exchange.
  
  
  RESULTS
  A total of 73 patients met inclusion criteria (46 in the self-centering catheter group and 27 in the standard split-tipped group). Mean durations of the exchanged catheters were similar between groups. The mean 1-, 3-, and 6-month patency rates for the self-centering and split-tip catheters were 89%, 67.4%, and 23.9% and 81.5%, 40.7%, and 14.8%, respectively. Mean blood flow rates (BFRs) were similar between groups at 1 and 3 months; however, at 6 months, mean rates were 388 mL/min versus 352 mL/min for the self-centering group and split-tipped group, respectively (p&lt;0.01).
  
  
  CONCLUSIONS
  These results demonstrate improved patency with the CentrosFLO self-centering catheter versus the split-tip catheter. This may be due to the unique design of the self-centering catheter, allowing for preserved BFRs and patency. These results should be further explored in prospective, randomized multicenter studies.
authors.affiliation: Tarrant Vascular Access Center, Vascular and Interventional Nephrology, Fort Worth, Texas - USA.|Nephrology Division, Department of Medicine, University of North Texas, Fort Worth, Texas - USA.
authors.forename: Saravanan
authors.initials: S
authors.lastname: Balamuthusamy
authors.affiliation: Tarrant Vascular Access Center, Vascular and Interventional Nephrology, Fort Worth, Texas - USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Nguyen
authors.affiliation: Tarrant Vascular Access Center, Vascular and Interventional Nephrology, Fort Worth, Texas - USA.
authors.forename: Suman
authors.initials: S
authors.lastname: Bireddy
authors.affiliation: Tarrant Vascular Access Center, Vascular and Interventional Nephrology, Fort Worth, Texas - USA.
authors.forename: Avinash
authors.initials: A
authors.lastname: Vallurapalli
authors.affiliation: Tarrant Vascular Access Center, Vascular and Interventional Nephrology, Fort Worth, Texas - USA.
authors.forename: Nishant
authors.initials: N
authors.lastname: Jalandhara
authors.affiliation: Tarrant Vascular Access Center, Vascular and Interventional Nephrology, Fort Worth, Texas - USA.
authors.forename: Dapo
authors.initials: D
authors.lastname: Afolabi
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D061807:Catheter Obstruction / Q000209:etiology; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling; D062905:Central Venous Catheters; D020878:Device Removal; D004867:Equipment Design; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012039:Regional Blood Flow; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D013781:Texas; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency