THE INCIDENCE OF SUBCLAVIAN VEIN STENOSIS USING SILICONE CATHETERS FOR HEMODIALYSIS

Complications related to the use of silicone subclavian catheters for hemodialysis were prospectively studied in 21 consecutive patients wit h acute and chronic renal failure. Between July 1991 and December 1992 , 34 double-lumen silicone catheters (Medcomp; 12 French; 20 or 24 cm) were inserted in 21 patients. The mean duration of catheterization wa s 20 days (range, 2-58 days). Venograms were performed in 16 patients (22 subclavian veins) within 6 months following removal of the cathete r. Excluded from angiography were patients whose catheters had been in place less than 1 week or who underwent fewer than 3 dialysis session s because of minor risk of stenosis. Patients who had ipsilateral repe ated catheters were also excluded. Two angiographies showed subclavian vein stenosis, both occurring in the same patient. One showed 50% ste nosis with collaterals; one showed 50% stenosis without collaterals. O ne other complication was a pneumothorax. Catheter thrombosis was obse rved in 3 patients; catheter sepsis did not occur. We conclude that us e of silicone catheters for subclavian cannulation is safe and effecti ve to provide temporary vascular access for acute hemodialysis. The in cidence of subclavian vein stenosis is lower compared with polytetrafl uoroethylene and polyurethane catheters.