Peritoneal dialysis (PD) catheters can be placed by interventional radiologists, an approach that might offer scheduling efficiencies, cost-effectiveness, and a minimally invasive procedure. In the United States, changes in the dialysis reimbursement structure by the Centers for Medicare and Medicaid Services are expected to result in the increased use of PD, a less costly dialysis modality that offers patients the opportunity to receive dialysis in the home setting and to have more independence for travel and work schedules, and that preserves vascular access for future dialysis options.

Experiences with minimally invasive techniques for peritoneal dialysis (PD) catheter placement are being increasingly described. Percutaneous placement of catheters using ultrasound and fluoroscopic guidance has reduced the risk of complications and has led to successful long-term catheter function. An interventional radiology catheter placement capability was established at our facility and it serves as the basis for this report.We performed a retrospective analysis of patients in a tertiary care center in Northern California who required PD between July 2005 and October 2008. Patients underwent PD catheter placement in an interventional radiology suite by the radiologist using a percutaneous Seldinger technique that was guided by fluoroscopy.Sixty-four patients between the ages of 25 and 90 were referred for fluoroscopic PD catheter placement by an interventional radiologist. If clinically indicated, PD was initiated within days of catheter placement. Minor complications were noted: four with minor bleeding, three with catheter migration, and one with temporary exit-site leakage. No bowel or bladder perforations were encountered.Fluoroscopically guided PD catheter placement by interventional radiologists can be a safe and cost-effective strategy to initiate acute or chronic PD. This approach could reduce the need for temporary vascular access and expedite the initiation of PD therapy by eliminating the delays in catheter placement often associated with surgical consultation and operating room scheduling.