Radiologisch implantierte subkutan getunnelte zentrale Venenkatheter zur Dialyse : Verlauf und Komplikationen

PURPOSE: The aim of the present study was to evaluate the efficacy of fluoroscopically controlled implantation of subcutaneous tunneled single- or double-lumen-catheters for short- and long-term dialysis. PATIENTS AND METHODS: In total, 104 patients were implanted with either a single-lumen Demer catheter or a Permcath double-lumen catheter into the subclavian vein under fluoroscopic control. RESULTS: In 99 of 104 cases (= 95.2%) the implantation remained without complications. Implantation-related occurrences included one pneumothorax, one mediastinal haematoma and one death. 61.5% of the indwelling catheters remained in situ for the intended duration. In 78% of the patients, dialysis was carried out to completion. 37 explantations (38.3%) were required due to various factors including infection (5), thrombosis (3), dislocation (9) and malfunction (20). The average duration of implantation was 59.1 days (range 1-851 days). CONCLUSIONS: Fluoroscopic-controlled implantation of subcutaneous tunneled catheters for dialysis is superior to surgically implanted catheters with regard to lower rates of infections and is equally reliable in respect of rates of complication and patency. Thus, this mode of implantation is a safe and reliable alternative to other procedures as access for haemodialysis.