IMAGE-GUIDED INSERTION OF THE ULDALL TUNNELED HEMODIALYSIS CATHETER -TECHNICAL SUCCESS AND CLINICAL FOLLOW-UP

PURPOSE: To evaluate the technical success, complication rates, and su rvival time of the Uldall double-lumen catheter placed by intervention al radiologists in patients presenting to a hemodialysis clinic. MATER IALS AND METHODS: Patients eligible for this study included those with end-stage renal disease (ESRD) who had failed peripheral vascular acc ess or who were awaiting access at a hemodialysis unit between June 19 93 and March 1996. All catheters were placed under fluoroscopic and ul trasound guidance in the angiography suite. RESULTS: Attempts were mad e to insert 130 catheters into jugular veins in a consecutive series o f 61 patients with ESRD, The accumulated catheter experience in this c ohort was 15,380 days and the median survival time was 141 days (95% c onfidence interval [CI]; 116 days-166 days), One hundred twenty-one ca theters (93%) were successfully inserted, mainly (94%) into the intern al jugular vein, Excellent dialysis blood flow rate was obtained-on av erage 365 mL/min (95% CI; 350-379 ml/min). The overall infection rate, including exit site (n = 13), sepsis (n = 19), and clavicular osteomy elitis (n = 1), was 2.1 episodes per 1,000 catheter days. CONCLUSIONS: This catheter is recommended for acute and longer term hemodialysis f or patients without peripheral vascular access, It can be inserted per cutaneously, the same internal jugular vein can be used repeatedly wit h few complications and good blood flow, and the technique can be easi ly learned by any experienced angiographer.