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. 2015 Jul-Aug;28(4):E41-7.
doi: 10.1111/sdi.12358. Epub 2015 Mar 20.

Patency and Complications of Translumbar Dialysis Catheters

Fanna Liu  1   2 , Stacy Bennett  3 , Susana Arrigain  4 , Jesse Schold  4 , Robert Heyka  1 , Gordon McLennan  3 , Sankar D Navaneethan  1   5
Affiliations

Patency and Complications of Translumbar Dialysis Catheters

Fanna Liu et al. Semin Dial. 2015 Jul-Aug.

Abstract

Translumbar tunneled dialysis catheter (TLDC) is a temporary dialysis access for patients exhausted traditional access for dialysis. While few small studies reported successes with TLDC, additional studies are warranted to understand the short- and long-term patency and safety of TLDC. We conducted a retrospective analysis of adult patients who received TLDC for hemodialysis access from June 2006 to June 2013. Patient demographics, comorbid conditions, dialysis details, catheter insertion procedures and associated complications, catheter patency, and patient survival data were collected. Catheter patency was studied using Kaplan-Meier curve; catheter functionality was assessed with catheter intervals and catheter-related complications were used to estimate catheter safety. There were 84 TLDCs inserted in 28 patients with 28 primary insertions and 56 exchanges. All TLDC insertions were technically successful with good blood flow during dialysis (>300 ml/minute) and no immediate complications (major bleeding or clotting) were noted. The median number of days in place for initial catheter, secondary catheter, and total catheter were 65, 84, and 244 respectively. The catheter patency rate at 3, 6, and 12 months were 43%, 25%, and 7% respectively. The main complications were poor blood flow (40%) and catheter-related infection (36%), which led to 30.8% and 35.9% catheter removal, respectively. After translumbar catheter, 42.8% of the patients were successfully converted to another vascular access or peritoneal dialysis. This study data suggest that TLDC might serve as a safe, alternate access for dialysis patients in short-term who have exhausted conventional vascular access.

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Figures

Figure 1
Figure 1
Picture showing TLDC placement Translumbar catheter insertion procedure (IVC access was expedited by femoral vein directing)
Figure 2
Figure 2
Survival of translumbar dialysis catheters with 95% CI (censoring for removal at the completion of therapy, patient death, conclusion of the study with the catheter still functioning, or lost to follow up)
Figure 3
Figure 3
Reasons and rates of various catheter-related complications (during early and overall study period)
See this image and copyright information in PMC

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