Publication:

Modified over-the-wire technique for infected tunneled cuffed dialysis catheters exchange: a precious salvage procedure

Background One of the major troubles related to tunnelled cuffed catheters for hemodialysis is infection. The outcomes of conservative treatment, as an attempt to access salvage, are often poor.

Methods In the present retrospective study, authors reviewed all the patients who underwent infected tunneled cuffed dialysis catheter exchange through a modified over the wire technique. Briefly, this technique consisted in creating a new subcutaneous tunnel away from the old one, preserving the insertion site of the catheter to the vein.

Results Authors have performed infected catheter exchange with this technique in 59 patients. The success rate was 93.2%. Median follow-up was 9 months. There were only 4 patients with signs and symptoms of recurrent catheter infection treated with catheter removal.

Conclusions The modified technique may provide multiple benefits for patients with ESRD. Low recurrence rates, anatomic site preservation and cost effectiveness are some of the advantages of this technique.