Translumbar and Transhepatic Tunneled Dialysis Catheter Placements in the End Stage Renal Disease Population.

For end-stage renal disease (ESRD) patients requiring hemodialysis, reliable vascular access is crucial, especially when conventional supradiaphragmatic options are exhausted. This study reviews the technical aspects, clinical outcomes, and complications of translumbar and transhepatic tunneled dialysis catheter (TDC) placements. These alternative infradiaphragmatic approaches provide essential hemodialysis access for patients with central venous occlusions. Translumbar catheter placement is associated with high technical success rates and prolonged patency, while the transhepatic approach serves as a last resort for patients with both superior and inferior vena cava occlusions. Careful patient selection and operator expertise are critical for placement of these advanced infradiaphragmatic dialysis catheter approaches.