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  • Title: Insertion of tunneled hemodialysis catheters without fluoroscopy.
    Author: Motta Elias R, da Silva Makida SC, Abensur H, Martins Castro MC, Affonso Moysés RM, Pereira BJ, Bueno de Oliveira R, Luders C, Romão JE.
    Journal: J Vasc Access; 2010; 11(2):138-42. PubMed ID: 20175069.
    Abstract:
    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. CONCLUSION: 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.
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