engleski

Long-term Survival a Tesio Twin Catheter for Hemodialysis Access – Case Report

Background: In some patients construction of an arterio-venous fistula (AVF) is not always possible. During haemodialysis treatment, there might be a deterioration of vascular access, so that it is no possible to construct a new AVF or graft. In these patients the only way to carry out the hemodialysis procedure is a central venous catheter. We reported patient who had permanent venous catheter 15 years. Case report: Our patient was a woman, who started regular haemodialysis treatment in 1988 at the age of 49. She had four AVF to provide access, but they ceased to function because of thrombosis. At the age of 58, after nine years of hemodialysis treatment, construction of new AVF was not possible, the patient received an permanent, i.e. tunneled, of a Tesio catheter from Medcomp (52 cm long, 10 F, a twin-line single –lumen). The catheter was inserted in the right internal jugular vein. The insertion point was between the sternal and clavicular heads of the stenocleidomastoid muscle. The technique used was a two-puncture two-guide wire in sterile condition under the fluoroscopic control. The catheter was implanted by a nephrologist in the university hospital. The patient continued regular dialysis in a small dialysis center with less than 20 patients. The implanted catheter functioned for 15 years until 21 March 2012 when a appeared fracture on the one lumen catheter, at thepoint of exit from the subcutaneous tunnel. Catheter had to be removed. During the 15 years patient had only one episode catheter infection. The blood flow rates was between 300-400 ml/min, the doses dialysis was good, Kt/V >1.2. The catheter was locked between dialysis treatment with heparin and wasn’t used for other purposes. On 21 March 2012, the patient underwent a procedure to replace the damaged catheter. The extracted catheter was thoroughly examined. The part of it that was in the patient’s body was macroscopically of a normal shape. It was not damaged and was completely passable. Conclusion: The permanent catheter is a good option for vascular access for haemodialysis treatment. Catheter survival time in the body can be more years and even up to 15 years as in the case reported.

Hemodialysis; Tesio catheter; Vascular access

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