Initial clinical experience with a new heparin‐coated chronic hemodialysis catheter

Abstract

In this paper we wish to report our clinical experience with a new heparin-coated dialysis catheter with a symmetric tip. Over a 16-month period, 60 heparin-coated Tal Palindrome catheters were placed in 57 patients. Catheter patency, catheter-related complications, and reasons for catheter removal were recorded. The patient's initial cause of end-stage renal disease, underlying diseases, and site of access were recorded as well. Patients were specifically followed for development of heparin-induced thrombocytopenia. Patient ages were 34-91 (average 66). Fifty-four percent of patients had a history of diabetes. Sixty catheters were placed for a total of 5353 catheter-days. The average catheter indwell time was 107 days (range of 2-381 days). Catheter-related infection occurred in 6 patients over the study period, with a rate of 1.12/1000 catheter-days. Bacteremia occurred in 3 patients with a rate of 0.56/1000 catheter-days. Six catheters were removed or exchanged due to malfunction. There was no incidence of heparin-induced thrombocytopenia. Initial clinical experience with the heparin-coated Tal Palindrome hemodialysis catheter demonstrated safe, reliable use, and low infection rates.

Urea‐based recirculation validation of the symmetrical palindrome catheter

“…These results could also be achieved with the presented catheter. A study from Spector et al () and from Mojibian et al () showed that the palindrome catheter had an implantation success rate of 100% which was also the case in this study.…”

Traditional and non-traditional strategies to optimize catheter function: go with more flow

“…There has already been over a decade of research into surface modification of medical devices to enhance thromboresistance, such as isolated heparin coating, antithrombin-heparin covalent complex coating, coatings that enhance nitric oxide release and heparin immobilization, as well as others. 27,[60][61][62][63][64][65][66][67] These data suggest that such anticoagulant coatings protect against platelet deposition, fibrin sheath formation, and devicerelated thrombosis. However, clinical data on surfacemodified HD catheters are limited (Table 1c).…”

Comparison of the efficacy of two types of hemodialysis catheters: the VectorFlow vs. Palindrome catheters

“…The spiral Z-shaped tip of the Palindrome was designed to decrease blood recycling rate. Previous studies reported efficacy of the Palindrome catheter 4,9 . The VectorFlow catheter for use in hemodialysis patients was cleared by the FDA (Food and Drug Administration) in 2014 10 .…”