Background: Tunneled dialysis catheters (TDCs) are inserted for hemodialysis (HD in patients with chronic kidney diseases (CKD), with failed arterio-venous fistula (AV). Tunneled femoral vein catheters are commonly used with exhausted internal jugular or subclavian veins catheters. Aim of study:To evaluate flow rate and complications associated with femoral vein catheters for long term HD and to compare the effectiveness of hemodialysis (HD) in cases of high tip versus low tip placement of the catheter.Patients and methods: 40 cases with the only vascular access is the femoral veins. The flow rate, complications and difference between high and low placement of the catheters were investigated.Results: Among the mean URR of the studied cases was 63.58 (±7.62 SD) with range (52-74.8), the mean Kt/V was 1.03 (±0.22 SD) with range (0.73-1.38) and the mean Kt/V was 238.5 (±33.51 SD) with range (182-297). Conclusion:The complication rate of femoral venous catheters appears to be acceptable. Flow rate is better in high tip placed catheters.

Background:Patients who suffers from central venous occlusion (CVO) or central venous stenosis (CVS) with no options for vascular access (VA) need urgent HD.Purpose: To evaluate CVO or CVS endovascular veinoplasty through an occluded access site to insert tunnelled catheter for HD.Patients and methods: Patients included had no options for VA and had CVO or CVS.Results: 124 patients on HD had endovascular veinoplasty. Technical success was 100% and 79% for CVS and CVO. Mean follow-up period was 36.16±12.6 months. Primary catheter site patency was 70%, 40%, 20%, and 5% after one, two, three, and four years. Assisted primary catheter site patency was 77%, 45%, 27%, and 12% and access vein survival was 100%, 80%, 40%, and 15% respectively at one, two, three, and four years, respectively. Conclusion:Recanalizing occluded veins for catheter insertion is simple, cost-effective, and safe.