Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2023; 33(01): 076-079
DOI: 10.1055/s-0042-1758877
Review Article

Tunneled Hemodialysis Catheter Insertion: Technical and Clinical Considerations

Julian Yaxley
1   Department of Nephrology, Cairns Hospital, Cairns, Queensland, Australia
2   John Flynn Private Hospital, Tugun, Queensland, Australia
3   Department of Nephrology, Gold Coast University Hospital, Southport, Queensland, Australia
› Author Affiliations Funding None.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Tunneled hemodialysis catheter insertion is a common and important procedure. Clinicians involved in the placement or maintenance of tunneled catheters require an appreciation of their best clinical application. Although comprehensive guidelines are available, many aspects of the published literature on this subject remain uncertain. This primer offers a concise, evidence-based discussion of 10 fundamental, everyday questions with respect to tunneled hemodialysis catheter insertion.

Keywords

catheter - dialysis - interventional - nephrology - tunneled


Publication History

Article published online:
07 December 2022

© 2022. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Pisoni RL, Young EW, Dykstra DM. et al. Vascular access use in Europe and the United States: results from the DOPPS. Kidney Int 2002; 61 (01) 305-316
    CrossrefPubMedGoogle Scholar
  • 2 ANZDATA Registry. ANZDATA Annual Report 2019–Chapter 4–Haemodialysis. Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia. 2019. Accessed September 23, 3022 at: http://www.anzdata.org.au
    Google Scholar
  • 3 Yaxley J, Palamuthusingam D, Burke M, Mantha M. Interventional nephrology in Australia and New Zealand. J Vasc Access 2022; DOI: 10.1177/1129729822107777611297298221077776.
    CrossrefGoogle Scholar
  • 4 Clark E, Barsuk JH, Karpinski J, McQuillan R. Achieving procedural competence during nephrology fellowship training: current requirements and educational research. Clin J Am Soc Nephrol 2016; 11 (12) 2244-2249
    CrossrefPubMedGoogle Scholar
  • 5 Aerden D, van Hooland S, Moerman L, Pipeleers L, Debing E, Van den Brande P. Establishing the learning curve for a tunneled dialysis catheter placement. J Vasc Access 2012; 13 (01) 86-90
    CrossrefPubMedGoogle Scholar
  • 6 American Society of Diagnostic and Interventional Nephrology. Application for certification: tunnelled long-term catheter procedures. Clinton MS: American Society of Diagnostic and Interventional Nephrology; 2020: 9
    Google Scholar
  • 7 Advanced Training Unit [Internet]. Melbourne VIC. Royal Australasian College of Physicians; 2021. Advanced Training in Nephrology 2020–21 Program Requirements Handbook. 2022 [cited 2022 Mar 9]; [about 4 screens]. Accessed September 23, 3022 at: https://www.racp.edu.au/trainees/advanced-training/advanced-training-programs/nephrology
  • 8 Specialty Training Unit [Internet]. Sydney NSW. Royal Australian and New Zealand College of Radiologists; 2022. Clinical radiology training program handbook. 2022 [cited 2022 Mar 9]; [about 3 screens]. Accessed September 23, 2022 at: https://www.ranzcr.com/doclink/clinical-radiology-training-program-handbook-draft-version-1-0
  • 9 Kelber J, Delmez JA, Windus DW. Factors affecting delivery of high-efficiency dialysis using temporary vascular access. Am J Kidney Dis 1993; 22 (01) 24-29
    CrossrefPubMedGoogle Scholar
  • 10 Leblanc M, Bosc JY, Paganini EP, Canaud B. Central venous dialysis catheter dysfunction. Adv Ren Replace Ther 1997; 4 (04) 377-389
    CrossrefPubMedGoogle Scholar
  • 11 Guillermo-Corpus G, Ramos-Gordillo JM, Peña-Rodríguez JC. Survival and clinical outcomes of tunnelled central jugular and femoral catheters in haemodialysis patients. Blood Purif 2019; 47 (1-3): 132-139
    CrossrefPubMedGoogle Scholar
  • 12 Abidi SM, Khan A, Fried LF, Chelluri L, Bowles S, Greenberg A. Factors influencing function of temporary dialysis catheters. Clin Nephrol 2000; 53 (03) 199-205
    PubMedGoogle Scholar
  • 13 Leblanc M, Fedak S, Mokris G, Paganini EP. Blood recirculation in temporary central catheters for acute hemodialysis. Clin Nephrol 1996; 45 (05) 315-319
    PubMedGoogle Scholar
  • 14 Fry AC, Stratton J, Farrington K. et al. Factors affecting long-term survival of tunnelled haemodialysis catheters–a prospective audit of 812 tunnelled catheters. Nephrol Dial Transplant 2008; 23 (01) 275-281
    CrossrefPubMedGoogle Scholar
  • 15 Shafique MN, Akhtar SH, Mahnoor M, Hussain M. Hemodialysis internal jugular vein versus subclavian vein catheters: complications, patients' comfort, tolerance and cost-effectiveness. Pak J Med Sci 2019; 35 (01) 124-128
    CrossrefPubMedGoogle Scholar
  • 16 Moini M, Rasouli MR, Kenari MM, Mahmoodi HR. Non-cuffed dual lumen catheters in the external jugular veins versus other central veins for hemodialysis patients. Saudi J Kidney Dis Transpl 2009; 20 (01) 44-48
    PubMedGoogle Scholar
  • 17 Parienti JJ, Mongardon N, Mégarbane B. et al; 3SITES Study Group. Intravascular complications of central venous catheterisation by insertion site. N Engl J Med 2015; 373 (13) 1220-1229
    CrossrefPubMedGoogle Scholar
  • 18 Ruesch S, Walder B, Tramèr MR. Complications of central venous catheters: internal jugular versus subclavian access–a systematic review. Crit Care Med 2002; 30 (02) 454-460
    CrossrefPubMedGoogle Scholar
  • 19 Shin HJ, Na HS, Koh WU. et al. Complications in internal jugular vs subclavian ultrasound-guided central venous catheterization: a comparative randomized trial. Intensive Care Med 2019; 45 (07) 968-976
    CrossrefPubMedGoogle Scholar
  • 20 Hawkins JL. American society of anesthesiologists' practice guidelines for obstetric anesthesia: Update 2006. Int J Obstet Anesth 2007; 16 (02) 103-105
    CrossrefPubMedGoogle Scholar
  • 21 Zafarghandi MR, Nazari I, Taghavi M, Salimi J, Moini M, Askarpour S. Comparison of results of placement of cuffed -tunneled hemodialysis catheter in internal jugular vein with subclavian vein for long -term dialysis. Pol Przegl Chir 2013; 85 (03) 133-136
    CrossrefPubMedGoogle Scholar
  • 22 Adwaney A, Lim C, Blakey S, Duncan N, Ashby DR. Central vein stenosis, access outcome and survival in patients undergoing maintenance haemodialysis. Clin J Am Soc Nephrol 2019; 14 (03) 378-384
    CrossrefPubMedGoogle Scholar
  • 23 MacRae JM, Ahmed A, Johnson N, Levin A, Kiaii M. Central vein stenosis: a common problem in patients on hemodialysis. ASAIO J 2005; 51 (01) 77-81
    CrossrefPubMedGoogle Scholar
  • 24 Zhou Y, Lan Y, Zhang Q. et al. Totally implantable venous access ports: a systematic review and meta-analysis comparing subclavian and internal jugular vein punctures. Phlebology 2022; 37 (04) 279-288
    CrossrefPubMedGoogle Scholar
  • 25 Wu S, Huang J, Jiang Z. et al. Internal jugular vein versus subclavian vein as the percutaneous insertion site for totally implantable venous access devices: a meta-analysis of comparative studies. BMC Cancer 2016; 16 (01) 747
    CrossrefPubMedGoogle Scholar
  • 26 Han L, Zhang J, Deng X. et al. Totally implantable venous access ports: a prospective randomized study comparing subclavian and internal jugular vein punctures in children. J Pediatr Surg 2021; 56 (02) 317-323
    CrossrefPubMedGoogle Scholar
  • 27 Oguzkurt L, Tercan F, Torun D, Yildirim T, Zümrütdal A, Kizilkilic O. Impact of short-term hemodialysis catheters on the central veins: a catheter venographic study. Eur J Radiol 2004; 52 (03) 293-299
    CrossrefPubMedGoogle Scholar
  • 28 Kidney Disease Outcomes Quality Initiative [Internet]. New York City NY. National Kidney Foundation; 2006. Clinical practice guidelines and clinical practice recommendations – 2006 updates. 2022 [cited 2022 Mar 9]; [about 2 screens]. Accessed September 23, 2022 at: https://www.kidney.org/sites/default/files/docs/12-50-0210_jag_dcp_guidelines-hd_oct06_sectiona_ofc.pdf
    Google Scholar
  • 29 Lorente L, Henry C, Martín MM, Jiménez A, Mora ML. Central venous catheter-related infection in a prospective and observational study of 2,595 catheters. Crit Care 2005; 9 (06) R631-R635
    CrossrefPubMedGoogle Scholar
  • 30 Parienti JJ, Thirion M, Mégarbane B. et al; Members of the Cathedia Study Group. Femoral vs jugular venous catheterization and risk of nosocomial events in adults requiring acute renal replacement therapy: a randomized controlled trial. JAMA 2008; 299 (20) 2413-2422
    CrossrefPubMedGoogle Scholar
  • 31 Maya ID, Allon M. Outcomes of tunneled femoral hemodialysis catheters: comparison with internal jugular vein catheters. Kidney Int 2005; 68 (06) 2886-2889
    CrossrefPubMedGoogle Scholar
  • 32 Tampe D, Tampe B. Determinants of tunnelled haemodialysis catheter implantation time by ultrasound guidance: a single-center cross-sectional study. J Clin Med 2022; 11 (12) 1-8
    CrossrefPubMedGoogle Scholar
  • 33 Shingarev R, Barker-Finkel J, Allon M. Natural history of tunneled dialysis catheters placed for hemodialysis initiation. J Vasc Interv Radiol 2013; 24 (09) 1289-1294
    CrossrefPubMedGoogle Scholar
  • 34 Osman OO, El-Magzoub AR, Elamin S. Prevalence and risk factors of central vein stenosis among prevalent haemodialysis patients; a single center experience. Arab J Nephrol Transplant 2014; 7 (01) 45-47
    PubMedGoogle Scholar
  • 35 Lok CE, Huber TS, Lee T. et al; National Kidney Foundation. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis 2020; 75 (4, Suppl 2) S1-S164
    CrossrefPubMedGoogle Scholar
  • 36 CARI Guidelines [Internet]. Westmead NSW. Caring for Australians and New Zealanders with Renal Impairment; 2012. Insertion of catheters. 2022 [cited 2022 Mar 7]; [about 3 screens]. Accessed September 23, 2022 at: https://www.cariguidelines.org/guidelines/dialysis/vascular-access/insertion-of-catheters/
  • 37 Chang Z, Wong W, Chan Y, Khan B, Leo C. Comparing outcomes of tunnelled dialysis catheter insertions and exchanges with or without fluoroscopy. J Vasc Access 2022; 23 (03) 443-449
    CrossrefPubMedGoogle Scholar
  • 38 Farrell J, Gellens M. Ultrasound-guided cannulation versus the landmark-guided technique for acute haemodialysis access. Nephrol Dial Transplant 1997; 12 (06) 1234-1237
    CrossrefPubMedGoogle Scholar
  • 39 Farrell J, Walshe J, Gellens M, Martin KJ. Complications associated with insertion of jugular venous catheters for hemodialysis: the value of postprocedural radiograph. Am J Kidney Dis 1997; 30 (05) 690-692
    CrossrefPubMedGoogle Scholar
  • 40 Mauro M, Murphy K, Thomson K, Venbrux A, Morgan R. Image-Guided Interventions. 2nd ed.. Philadelphia: Elsevier Saunders Inc; 2014: 869-875
    Google Scholar
  • 41 Beathard GA, Urbanes A, Litchfield T. The risk of bleeding with tunneled dialysis catheter placement. J Vasc Access 2016; 17 (05) 397-400
    CrossrefPubMedGoogle Scholar
  • 42 Patel IJ, Rahim S, Davidson JC. et al. Society of Interventional Radiology Consensus Guidelines for the periprocedural management of thrombotic and bleeding risk in patients undergoing percutaneous image-guided interventions – part II: recommendations. J Vasc Interv Radiol 2019; 30 (08) 1168-1184.e1
    CrossrefPubMedGoogle Scholar
  • 43 Patel IJ, Davidson JC, Nikolic B. et al; Standards of Practice Committee, with Cardiovascular and Interventional Radiological Society of Europe (CIRSE) Endorsement. Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol 2012; 23 (06) 727-736
    CrossrefPubMedGoogle Scholar
  • 44 Department of Health. Guideline – tunnelled central venous catheters. Brisbane QLD: Queensland Government; 2015
    Google Scholar
  • 45 Bishop L, Dougherty L, Bodenham A. et al. Guidelines on the insertion and management of central venous access devices in adults. Int J Lab Hematol 2007; 29 (04) 261-278
    CrossrefPubMedGoogle Scholar
  • 46 Hentrich M, Schalk E, Schmidt-Hieber M. et al; Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology. Central venous catheter-related infections in hematology and oncology: 2012 updated guidelines on diagnosis, management and prevention by the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology. Ann Oncol 2014; 25 (05) 936-947
    CrossrefPubMedGoogle Scholar
  • 47 van de Wetering MD, van Woensel JB. Prophylactic antibiotics for preventing early central venous catheter Gram positive infections in oncology patients. Cochrane Database Syst Rev 2007; (01) CD003295
    PubMedGoogle Scholar