{"title":"Long-Term Durability of Tunneled Hemodialysis Catheters: Outcomes from a Single Institution 22-Year Experience.","authors":"Austin Zhang, Timothy Wi Clark, Scott O Trerotola","doi":"10.1007/s00270-024-03941-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To describe long-term physical durability of tunneled hemodialysis catheters, highlighted in the 2019 Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines as a specific area for future research.</p><p><strong>Materials and methods: </strong>Tunneled hemodialysis catheters with known outcomes and dwell times > 1 year were entered into this retrospective study. Data includes demographics, complications, catheter type, dwell time, reason for removal, access site, and placement via exchange or de novo. Catheter durability < 1 year dwell was analyzed as a secondary aim.</p><p><strong>Results: </strong>272 catheters in 229 patients were included. Dwell times ranged from 366 to 3,802 days (median 504), totaling 162,439 catheter days. 17 (6%) catheters > 1 year dwell had broken external components. For these, dwell times until breaking ranged from 377 to 1,436 days (median 489), totaling 10,434 catheter days. 5 had a broken hub, 11 had a broken clamp, and 1 had broken hub and clamp. 12 were Ash Split Cath (n = 240) and 5 were Arrow-Clark VectorFlow (n = 32). In the durability < 1 year sub-analysis, 6,515 catheters with dwell times < 1 year in 3,693 patients were included, totaling 425,018 catheter days. 48 were damaged, with 24 broken hubs, 17 broken clamps, and 7 holes. Median time to breakage was 110 days. 38 were Ash Split Cath (n = 5,636) and 10 Arrow-Clark VectorFlow (n = 812). In both analyses, breakage was limited to hubs, clamps, and extensions.</p><p><strong>Conclusions: </strong>Tunneled hemodialysis catheters are exceptionally durable, rarely requiring removal for hub-related issues after one year. Breakdown was not observed as a long-term durability issue. Further, broken external components can be replaced using external repair kits.</p><p><strong>Level of evidence: </strong>Level 2b, Retrospective Study.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"CardioVascular and Interventional Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00270-024-03941-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To describe long-term physical durability of tunneled hemodialysis catheters, highlighted in the 2019 Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines as a specific area for future research.
Materials and methods: Tunneled hemodialysis catheters with known outcomes and dwell times > 1 year were entered into this retrospective study. Data includes demographics, complications, catheter type, dwell time, reason for removal, access site, and placement via exchange or de novo. Catheter durability < 1 year dwell was analyzed as a secondary aim.
Results: 272 catheters in 229 patients were included. Dwell times ranged from 366 to 3,802 days (median 504), totaling 162,439 catheter days. 17 (6%) catheters > 1 year dwell had broken external components. For these, dwell times until breaking ranged from 377 to 1,436 days (median 489), totaling 10,434 catheter days. 5 had a broken hub, 11 had a broken clamp, and 1 had broken hub and clamp. 12 were Ash Split Cath (n = 240) and 5 were Arrow-Clark VectorFlow (n = 32). In the durability < 1 year sub-analysis, 6,515 catheters with dwell times < 1 year in 3,693 patients were included, totaling 425,018 catheter days. 48 were damaged, with 24 broken hubs, 17 broken clamps, and 7 holes. Median time to breakage was 110 days. 38 were Ash Split Cath (n = 5,636) and 10 Arrow-Clark VectorFlow (n = 812). In both analyses, breakage was limited to hubs, clamps, and extensions.
Conclusions: Tunneled hemodialysis catheters are exceptionally durable, rarely requiring removal for hub-related issues after one year. Breakdown was not observed as a long-term durability issue. Further, broken external components can be replaced using external repair kits.
期刊介绍：
CardioVascular and Interventional Radiology (CVIR) is the official journal of the Cardiovascular and Interventional Radiological Society of Europe, and is also the official organ of a number of additional distinguished national and international interventional radiological societies. CVIR publishes double blinded peer-reviewed original research work including clinical and laboratory investigations, technical notes, case reports, works in progress, and letters to the editor, as well as review articles, pictorial essays, editorials, and special invited submissions in the field of vascular and interventional radiology. Beside the communication of the latest research results in this field, it is also the aim of CVIR to support continuous medical education. Articles that are accepted for publication are done so with the understanding that they, or their substantive contents, have not been and will not be submitted to any other publication.
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