A randomized, prospective evaluation of the Tesio, Ash split, and Opti-flow hemodialysis catheters

PURPOSE: A randomized, prospective evaluation of three high-flow hemodialys is catheters. MATERIALS AND METHODS: Ninety-four patients were randomly assigned 113 Tesi o, Ash split, and Opti-flow catheters from December 1998 through Tune 1999. Insertion times, procedural complications, and ease of insertion were reco rded. Mean catheter flow rates were recorded at first dialysis, 30 days, an d 90 days. Patency, catheter survival, and catheter-related infections were evaluated. RESULTS: Thirty-eight Ash split, 39 Opti-flow, and 36 Tesio catheters were placed. Tesio mean insertion time (41.5 min) was significantly longer than Ash split (29.4 min) or Opti-flow (29.6 min) (P =.004). There were four com plications related to Tesio catheters (three cases of pericatheter bleeding , one air embolism), one related to an Opti-flow catheter (pericatheter ble eding), and zero related to Ash split catheters. Opti-flow and Ash split ca theters were significantly easier to insert than Tesio catheters (P =.041). Mean flow rates were not significantly different among the catheters initi ally (P =.112), at 30 days (P =.281), or at 90 days (P =.112). Catheter-rel ated infection rates per 100 catheter days were 0.12 for Ash split, 0.35 fo r Opti-flow, and 0.14 for Tesio. Median catheter survival was 302 days for Ash split, 176 days for Opti-flow, and 228 days for Tesio. CONCLUSIONS: Opti-Flow and Ash split catheters were faster and easier to pl ace than Tesio catheters. There was no difference in hemodialysis flow rate s or catheter survival.