Editor-in-Chief Ufuk Demirkılıç Frequency Quarterly Abbreviation Turk J Vasc Surg Publisher Turkish National Vascular and Endovascular Surgery Society E-ISSN 2667-5080

Turkish Journal of Vascular Surgery 2019 , Vol 28 , Issue 3
Patency and complications of patients with tunneled dialysis catheters: A long-term follow-up study
Emine Şeyma Denli Yalvaç1, Mehmet Şenel Bademci1, Cemal Kocaaslan1, Ahmet Öztekin1, Mustafa Aldağ1, Fatma Yılmaz Karadağ2, Handan Ankaralı3, Ebuzer Aydın1
1Department of Cardiovascular Surgery, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey
2Department of Infectious Diseases, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey
3Department of Biostatistics and Medical Informatics, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey
DOI : 10.9739/tjvs.2019.358 Objectives: This study aims to report long-term follow-up results including catheter patency and catheter dysfunction in patients with tunneled dialysis catheters (TDCs) during the treatment phase.

Patients and methods: Medical records of a total of 90 patients (54 males, 36 females; mean age 59.9±19 years; range, 19 to 89 years) with a combined total of 103 TDCs inserted by a single cardiovascular surgeon at our institution between January 2014 and December 2017 were reviewed retrospectively. Data including age, gender, duration of hospital stay, catheter patency, complications, and mortality were recorded. The patients were divided into two groups according to age: <60 years (n=41) and ≥60 years (n=49).

Results: Technical success was achieved without any procedural complications and hemodialysis was initiated following the catheter placement in all patients. The mean duration of catheter use was 729.6±58.4 (range, 20 to 1,100) days. Of all patients, 18 (20%) died within one year following the procedure. A total of 28 TDCs (24.77%) were electively removed, as these patients gained other types of permanent access. One of them underwent a kidney transplant. Catheter-related complications were observed in 24 patients (21.23%) and TDCs of 13 patients were replaced. Twelve complications (10.61%) were related to catheter dysfunction, and the remaining 12 were due to catheterrelated infections (CRIs). Ten of the patients with CRIs were treated successfully, while the remaining two died. No significant correlation was found between the catheter patency, catheter-related complications, and baseline characteristics of the patients, except for age. Younger age was a predictor of poor catheter patency (p=0.040). Fifty six patients (62%) who were discharged on the day of their catheter placement had significantly fewer complications than the hospitalized patients (p=0.011).

Conclusion: The prevention of TDC-related complications requires a careful insertion technique and extensive surgical experience. The TDC patency and reducing the number of complications are also closely associated with early discharge and the age of patient. Keywords : Catheter patency, catheter-related complication, catheter-related infection, long-term follow-up, surgical experience, tunneled dialysis catheter

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