title: Maintenance of blood flow rate on dialysis with self-centering CentrosFLO catheter: A multicenter prospective study.
abstract: Introduction Chronic central venous catheters (CVC) for dialysis lose patency and deliver lower blood flow over time, often due to fibrous sheathing that covers the lumen tips. The CentrosFLO central venous catheter has a shape that directs the arterial and venous tips away from the walls of the vena cava and right atrium, making sheathing of the tips less likely. Methods A prospective, multicenter, single arm, non-controlled, observational study was conducted at eight sites in the United States. All consenting dialysis patients receiving CentrosFLO catheters through the right or left internal jugular veins were accepted in the study, as long as the catheter was expected to be used for 45 days and was not an over-the-wire replacement for a previous CVC. Data were automatically collected on initial and average dialysis blood flow rate and initial arterial and venous pressures, for up to 26 weeks of dialysis therapy. Findings 75 patients were enrolled. Kaplan-Meier analysis indicated that 87% of patients maintained blood flow rate over 300 mL/min throughout 26 weeks of follow-up. There was no decline in average dialysis blood flow rate and no significant change in hydraulic resistance of the arterial or venous lumens of the catheters during the study. Discussion The CentrosFLO catheter demonstrates long term patency with good flow rates on dialysis, which, by comparison with previous studies, shows a clinically significant improvement in blood flow rate vs. other catheters. Stable hydraulic resistance of the catheter lumens showed no evidence of tip encroachment by fibrous sheaths.
authors.affiliation: Professor of Medicine, Chief, Section of Nephrology at University Hospiital East, Director, Interventional Nephrology, Director of Clinical Scholarship for FAME, The Ohio State University Wexner Medical Center, Columbus, Ohio, 43210, USA.
authors.forename: Anil K
authors.initials: AK
authors.lastname: Agarwal
authors.affiliation: Nephrology Department, Indiana University Health Arnett, Ash Access Technology, Inc. and HemoCleanse Technologies, LLC, 3601 Sagamore Parkway North, Suite B, Lafayette, Indiana, 47905, USA. sash@hemocleanse.com.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Ash
authors.affiliation: Principal Investigators of the CentrosFLO Trial: Akram Al-Makki, Indiana University Health Arnett; Anil Agarwal, Ohio State University; Aslam Pervez, Southwest Kidney Institute, PLC; Tung Huynh, Arrowhead Regional Medical Center; Anton Cabellon, Indiana University Health; Margaret Lee, Olive View-UCLA Education & Research Institute; Nishant Jalandhara, Sierra Nephrology Consultants; Dapo Afolabi, Tarrant Nephrology.
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D002405:Catheterization, Central Venous / Q000009:adverse effects; D062905:Central Venous Catheters; D005260:Female; D006801:Humans; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods*
keywords: Central venous catheters for dialysis; CentrosFLO catheter; blood access; catheters; fibrous sheaths