Permanent twin catheter: a vascular access option of choice for haemodialysis in the elderly patients

Canaud, Bernard; Leray‐Moragues, Hélène; Garrigues, V.; Mion, C

doi:10.1093/ndt/13.suppl_7.82

Cited by 28 publications

(21 citation statements)

References 9 publications

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“…For bacteremia expressed per 1,000 catheter days it varies from 0.5 to 6.5/1,000 catheter days [16-18, 29-31,], not far from our 1.1/1,000 catheter days. Expressed in percentage of infected catheter it varies from 5 to 16% [3,5,7,8,16,24]. We found 27% for TC and 31% for PC.…”

Section: Infectionmentioning

confidence: 88%

“…Few data on catheter dysfunction rate are available and results are widely variable. For Canaud et al [8] dysfunction was seen very rarely in 0.8%, mechanical failure in 1.6%, and stenosis/thrombosis in 1.4%. Mustata et al [24] reported that 22/138 (16%) silastic catheters needed urokinase.…”

Section: Infectionmentioning

confidence: 89%

“…Comparing to other reported data, we showed no major differences. For Canaud et al [8] the median technical survival rate of TC was 912 days for catheters lasting more than 3 months. That is close to our 869 days for the same catheter without time restriction.…”

Section: Infectionmentioning

confidence: 97%

“…Tunneled catheters offer several advantages, e.g., they are easy to insert under local anesthesia, the hemodialysis session may be initiated immediately after insertion, and the blood flow achieved is 200-400 ml/min without a significant recirculation rate. Other advantages are the lower psychological stress for the patient in comparison with the A-V fistula puncture and the relatively long technical survival rate [8]. The major catheter-related problems are, on the one hand, dysfunctions due to different causes including malposition [9,10], kinking, intraluminal or central venous thrombosis [11][12][13], fibrin sleeve [14,15], hypovolemia [9].…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Outcome of Permanent Hemodialysis Catheters: A Controlled Study

Gadrey¹,

Charra²,

Chazot³

et al. 2001

Blood Purif

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Aims: Hemodialysis tunneled catheters are widely used nowadays. However, their complications, infection and dysfunction, remain much too frequent. Different types of tunneled silicone hemodialysis catheters are available. We prospectively compared the long-term outcome of the two most popular devices, Permcath cuffed double catheter and TwinCath uncuffed twin catheter, both inserted percutaneously. Methods: From January 1994 to April 1998, 125 tunneled catheters were inserted in the internal jugular vein of 86 chronic hemodialysis patients, 63 TwinCath MedComp^® (TC) and 62 Permcath Quinton^® (PC). They were prospectively followed looking for technical patency, infection and dysfunction rate. Results: TC were used more often for iterative access (52 vs. 25% , p = 0.01) and were inserted more frequently in the left internal jugular vein (59 vs. 16% p < 0.001). Their median technical survival rate was longer (869 vs. 433 days for PC, p < 0.01) with a 1-year patency rate of 80 vs. 53% (p = 0.002). Total catheter extrusion was also slightly less frequent with TC (4.7 vs. 9.6%), but partial extrusion happened more frequently (43 vs. 16%, p = 0.02). No significant difference in infection rate was observed, 0.77 for TC vs. 1.3 local infection/1,000 catheter days; 1.08 vs. 1.30 bacteremia/1,000 catheter days. A persistent catheter thrombosis was observed in 7.9 vs. 20.9% in PC (p = 0.04), the number of dysfunction was 10.5 vs. 24/1,000 days in use (p = 0.0001) and the number of urokinase infusion was 4.4 vs. 12/1,000 days (p = 0.001). PC needed more radiological interventions for dysfunction with endolumenal brushes (4 vs. 0) or fibrin sleeve removal (4 vs. 0). The vena cava thrombosis incidence was not different (2 vs. 3). Conclusion: Although the study was not randomized, TC appears more efficient allowing for a longer patency with a lower dysfunction rate than PC. This was reinforced by less favorable conditions of TC including more left jugular side and more iterative catheters. The cuff does not offer a better bacteriological barrier or protection against extrusion, and the TC seems at a less risk of fibrin sleeves. However, a large randomized study is needed to definitively conclude.

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Section: Infectionmentioning

confidence: 88%

Section: Infectionmentioning

confidence: 89%

Section: Infectionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Long-Term Outcome of Permanent Hemodialysis Catheters: A Controlled Study

Gadrey¹,

Charra²,

Chazot³

et al. 2001

Blood Purif

View full text Add to dashboard Cite

show abstract

“…However, catheters are occasionally used as a permanent vascular access, particularly in cases where alternative options are limited [3]. Although there are reports that show prolonged HD catheter for more than 5 years [4,5], how long catheters should be used when they are maintained as a permanent vascular access remains unknown. In our clinic, we continue to care for a patient with a tunneled cuffed catheter that has been used for 7 years without complications.…”

Section: Figmentioning

confidence: 99%