Tesio catheter: Radiologically guided placement, mechanical performance, and adequacy of delivered dialysis

PURPOSE: Tunneled catheters are an alternative means of vascular access for patients in need of hemodialysis who cannot undergo dialysis through a sur gical shunt. This study was undertaken to evaluate the performance of the T esio dialysis catheter. MATERIALS AND METHODS: A prospective study of the Tesio catheter was perfor med. Follow-up data regarding catheter function and adequacy of dialysis we re obtained from nine hemodialysis facilities. RESULTS: Seventy-nine Tesio catheters were placed in 71 patients. Immediate technical success was 99% (78 of 79 catheters). The procedure complication rate was 9% (seven catheters). Only two complications required interventio n: one fatal air embolism and one chest wall hematoma. Sixty-seven catheter s in 60 patients were followed up for a total of 4,367 catheter days. Overa ll, catheter-related infection occurred in 90% (six of 67 catheters). Prima ry catheter patency was 87% at 1 week, 82% at 1 month, 72% at 3 months, and 66% at 6 months. Mean blood flow was 286 mL/min immediately after insertio n, 301 mL/min at 3 months, and 306 mL/min at 6 months. Adequate dialysis do se as reflected by a urea reduction ratio of 60 or more or a urea kinetic m odeling, or Kt/V, value of 1.2 or more was observed on at least one occasio n for 74% and 76% of catheters, respectively. CONCLUSION: The Tesio catheter is a reasonable means of vascular access for patients who undergo dialysis but are not candidates for surgical shunt pl acement.