• Journal of the Korean Society of Radiology
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• v.16 no.3
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• pp.241-248
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• 2022

A guideline for determining the optimal catheter length according to the patient's physique during tunnel-type dialysis catheter insertion used in renal failure patients is presented, and the maintenance of the function of the dialysis catheter is evaluated. From October 1, 2015 to February 31, 2016, a total of 110 (male : female = 73 : 37) patients who underwent tunnel-type dialysis catheterization performed at our hospital were treated without using guidelines. The group was divided into A group, and the group treated using the guideline into B group. Results were analyzed statistically using SPSS 20.0. As a result of the dialysis catheter insertion procedure according to the use of guidelines, the function maintenance rate of group A was 81.8%, and the function maintenance rate of group B was 96.3%. In the case of tunnel dialysis catheter procedure, the function maintenance effect was statistically significant in the group treated using the guideline compared to the group not using it (p<0.05). It can be said that it is more effective when information on the patient's underlying disease is reflected in addition to the use of guidelines.

• Journal of Yeungnam Medical Science
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• v.37 no.3
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• pp.186-193
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• 2020

Background: Non-tunneled catheters (NTCs) are used for hemodialysis (HD) in many centers in which fluoroscopy is not easily accessed despite high complication rates and conditions requiring long-term HD. Therefore, here we aimed to evaluate the superiority of catheter-related outcomes after the application of tunneled cuffed catheter (TCC) without fluoroscopy versus unconditioned NTC insertion. Methods: We divided the participants into two phases: those receiving NTCs between March 2010 and February 2011 (phase I), and those receiving TCCs or NTCs between March 2011 and February 2012 (phase II). Catheter survival, nurse satisfaction, and reasons for catheter removal were analyzed. Results: Two hundred and sixty patients in phase I and 300 patients in phase II were enrolled in this study. The success rate of TCC insertion was 99.2%. The catheter survival rate in phase I was 65.5% at 1 month, while that in phase II was 74.9% at 1 month (p=0.023). We compared catheter survival between TCCs and NTCs for all periods regardless of phase. The TCC survival rate was higher than the NTC survival rate (p<0.001). Catheter-associated problems led to catheter removal in 97 patients (26.6%) in phase I and 68 patients (18.5%) in phase II (p=0.009). Among 14 HD nurses, all reported being satisfied with manipulation during pre-/post-HD, manupulation during HD, and overall. Eleven HD nurses (78.6%) reported being satisfied with the workload. Conclusion: Compared with unconditional NTC insertion for HD, TCC insertion without fluoroscopy improved the overall catheter survival and nurse satisfaction rates.

• Journal of the Korean Society of Radiology
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• v.84 no.2
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• pp.477-482
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• 2023

The subclavian vein is an uncommon route for tunneled hemodialysis catheter (tHDC) placement because of its potency for future dialysis access. However, when favored access routes have been exhausted because of repeated catheterization or limited life expectancy, the subclavian vein can be used for urgent hemodialysis. A subclavian catheterization has a technical problem. The subclavian vein often forms a right angle with the vena cava, and advancing stiff peel-away sheath can cause a vascular injury. However, raising the patient's arm can alter the position of the guidewire and, therefore, change the angle of the vein favorable for tHDC placement. Herein, we report two patients who underwent subclavian catheterization; one experienced an injury to the superior vena cava after undergoing the conventional procedure, whereas the other patient with raised arm during the catheterization procedure had safe catheter placement.