Since the introduction of large-bore catheters for acute hemodialysis 30 years ago, many problems with handling, material, and contamination of these catheters exist. Nevertheless, catheterization of the inferior and superior vena cava with a large-bore catheter has proved to be suitable as a rapid connection process for hemodialysis, hemofiltration, hemoperfusion, plasmapheresis, plasmaperfusion, among others. In a retrospective study with 2,741 large-bore catheters in 1,716 patients, the frequency of infections, thrombosis, bleeding, and other side effects was investigated. All complications and side effects are presented dependent on vascular access route. In total, the complication rate was 48.9% higher in subclavian puncture than in internal jugular puncture (24.8%). The highest complication rates for both vascular access routes were infections or septicemia; infections were observed in 19.5% of subclavian catheters versus 10% of internal jugular catheters.

Large-bore catheters for extracorporeal detoxification methods without and with treated surface with silver or silicone were investigated after removal with a scanning electron microscope and for bacterial colonization. In 42 large-bore catheters of three different materials, small deposits of fibrin and protein on the inner and outer surface were seen. This second layer covered the entire surface after 3 days and increased to a thickness of 3 to 60 microns during the following days. Bacterial colonization was observed in 38.1%. In contrast to these results, the catheters with the treated outer surface showed a very low thrombogenicity and a low contamination rate of 6.7%.

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