Sethi Jasmine, Gaur Mragank, Rathi Manish, Kohli Harbir S
Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Nephrol. 2022 Jul-Aug;32(4):371-374. doi: 10.4103/ijn.ijn_224_21. Epub 2022 May 20.
Tunneled femoral vein hemodialysis catheters are used when all other options for permanent vascular access or jugular central vein catheter are exhausted. There is little published literature on the outcome and survival of tunneled femoral vein catheters.
Using a retrospective database, we identified all tunneled femoral dialysis catheters placed in the Nephrology department of our institute over a one-and-half year period. The outcomes, complications, and patency of these procedures was retrospectively evaluated.
Out of total 21 patients, 14 were female and 7 males with a mean age of 45 (range 17-73 years) and about one-fourth had diabetes mellitus (26%). Right-sided femoral catheter insertion was performed in 18 patients (85.7%) and 3 patients underwent left-sided insertion. Technical success of placement was 100% with no immediate complications. Median follow up period was 24 days. Primary catheter patency at 30, 60, 90, and 180 days were 81, 29, 18, and 12.5%, respectively. Three patients (15.7%) developed catheter-related deep venous thrombosis. Three catheters (14.2%) were removed for catheter-related infection and seven (33.3%) were removed because of absent blood flow.
Our experience with tunneled femoral catheters revealed low catheter survival and significant complications (deep venous thrombosis and malfunction/occlusion).
当所有其他建立永久性血管通路的选择或颈内静脉置管方法均已用尽时，可使用带隧道的股静脉血液透析导管。关于带隧道的股静脉导管的结局和生存率的已发表文献很少。
我们利用一个回顾性数据库，确定了在我院肾脏病科1年半期间内放置的所有带隧道的股静脉透析导管。对这些操作的结局、并发症和通畅情况进行了回顾性评估。
在总共21例患者中，女性14例，男性7例，平均年龄45岁（范围17 - 73岁），约四分之一的患者患有糖尿病（26%）。18例患者（85.7%）进行了右侧股静脉导管置入，3例患者进行了左侧置入。置管技术成功率为100%，无即刻并发症。中位随访期为24天。导管在30、60、90和180天的首次通畅率分别为81%、29%、18%和12.5%。3例患者（15.7%）发生了与导管相关的深静脉血栓形成。3根导管（14.2%）因导管相关感染而拔除，7根导管（33.3%）因无血流而拔除。
我们使用带隧道的股静脉导管的经验显示导管生存率低，且有显著并发症（深静脉血栓形成和功能障碍/堵塞）。
