LONG-TERM PERFORMANCE AND COMPLICATIONS OF THE TESIO TWIN CATHETER SYSTEM FOR HEMODIALYSIS ACCESS

The Tesio twin catheter system (Medcomp, Harleysville, PA) was develop ed to overcome the problems with the existing central venous catheters in providing high-efficiency dialysis, such as inadequate blood flows , high recirculation rates, and need for surgical insertion. The relat ively large internal lumens and multiple side holes in a spiral patter n allow for high blood flow rates and lower tendency to thrombosis, In this series, 82 catheter pairs were placed in 75 patients and monitor ed for a period encompassing 231 patient-months, We achieved mean nomi nal blood pump flow rates of 400 +/- 6 mL/min and an average recircula tion of 4.6% +/- 0.5%, In 20 sets of catheters, a nominal blood flow r ate of 388 +/- 6 mL/min was measured ultrasonically at 352 +/- 8 mL/mi n, representing an error of 36 +/- 5 mL/min, Thrombosis of the cathete r occurred at a rate of one episode per 21 patient-months, and on all occasions responded to local instillation of urokinase, Despite having two exit sites, the infection rates were comparable to other catheter s: exit site infections occurred at a rate of one per 21 patient-month s and bacteremic episodes occurred at one per 11.5 patient-months, nec essitating catheter removal once per 46 patient-months, Based on these data, we believe that the Tesio twin catheter system is an excellent long- and short-term vascular access for providing high-efficiency dia lysis. (C) 1997 by the National Kidney Foundation, Inc.