HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wong, J. K. Articles by Gray, R. R. Search for Related Content PubMed PubMed Citation Articles by Wong, J. K. Articles by Gray, R. R. Social Bookmarking                      What's this?

Analysis of Early Failure of Tunneled Hemodialysis Catheters

¹ All authors: Department of Diagnostic Imaging, Foothills Medical Centre, 1403 29th St., N.W., Calgary, Alberta T2N 2T9, Canada.

OBJECTIVE. Tunneled hemodialysis catheters are often placed by the interventional radiology service using sonographic guidance and fluoroscopy for safe and optimal placement. The aim of this study was to determine the causes of early failure (7 days) of these catheters in our practice.

SUBJECTS AND METHODS. Data were prospectively collected for 639 radiologically placed tunneled hemodialysis catheters. The reason for catheter removal was recorded in each case. Tips of removed catheters were routinely sent for microbial culture.

RESULTS. Fifty-two (8.1%) of 639 catheters were removed within 7 days of insertion. Six (0.9%) of these had completed their purpose and had not failed; these were not included in the study. Of the 46 catheters having early failure, six (0.9%) were clotted and 12 (1.9%) were suspected of being infected, only three of which had a proven catheter-related infection. Twenty-eight catheters (4.4%) were removed for other reasons. In this group, the most common reasons were poor tip position (n = 9) and catheter replacement over a guidewire into a preexisting fibrin sheath (n = 8). Only two failed because of poor tip orientation. Other reasons for failure were kinked or pinched catheters (n = 4) and bleeding (n = 3), including one exsanguination, and two unknown reasons.

CONCLUSION. By paying careful attention to catheter tip position, searching diligently for the presence of a fibrin sheath when catheter exchanges are made over a wire, and better investigating presumed catheter infection, we could reduce the early failure rate by more than half, from 46 cases to 20 cases (nine cases of suspected infection were in fact not infected).

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				A. Falk Use of the brachiocephalic vein for placement of tunneled hemodialysis catheters. Am. J. Roentgenol., September 1, 2006; 187(3): 773 - 777. [Abstract] [Full Text] [PDF]

				T. P. Smith, J. M. Ryan, and D. N. Reddan Transhepatic Catheter Access for Hemodialysis Radiology, July 1, 2004; 232(1): 246 - 251. [Abstract] [Full Text] [PDF]