901 Hastada 1419 Kalıcı Tünelli Hemodiyaliz Kateteri Tecrübemiz Işığında Skopi ve Doppler Ultrason Kullanılmasının Erken ve Geç Dönem Sonuçlar Üzerine Etkisi

Objective: We have retrospectively reviewed our 1419 tunneled and cuffed permanent catheter placements in 901 patients between the dates of December 2000 to January 2012 for hemodialysis access. We investigated the importance and adventages of X-ray scopy and perioperative duplex ultrasonography (DUS) usage on patency and complication rates. Material and Methods: In our study strategy, patients were divided into two different groups; Group A and Group B. Group A was consisted of 719 permanent catheter application in 412 patients between the dates of December 2000 to January 2012. These patients were operated with a direct venous placement of their instruments. Group B was consisted of 700 catheter applications in 489 patients between the dates of January 2006 to January 2012. We used X-Ray scopy and DUS during the application of catheters. Results: We applicated permanent hemodialysis catheters in 105 patients once, in 184 patients twice, in 71 patients three times, in 34 four times and in 18 patients 5 times for Group A. In Group B, catheter replacement numbers were in 278 once, in 143 twice, in 51 three times and in17 four times. We were able to locate the permanent catheter to this localization in 44.4% of patients in Group A and 67.3% patients in Group B (p<0.05). We believe that using X-Ray scopy and DUS enhances right internal jugular vein insertion possiblities when compared to direct application. We saw a similar statistical difference occured between both groups for catheter dysfunctions in a longer follow-up period (53.6% to 29.4%, Group A and Group B, respectively) with presenting a calculated p value less than 0.05. Conclusions: Our initial preferred location is right internal jugular vein. X-Ray scopy and DUS during application provide higher patency rates with lower complication incidence when compared to direct insertion.