[Effect of catheter type on the functional survival of jugular access ports in chronic hemodialysis].

Silicone catheter (C) can be used in the hemodialysis setting as an alternative for the blood access. We analysed retrospectively the 3 types of the catheters used in 45 patients. 58 catheters were percutaneously inserted in the internal jugular vein (9 Bard (B)-Hickman; 17 Canaud (CD)-Vygon; 32 Permcath (PC)-Quinton). The indications were thrombosis or dysfunction of an arterio-venous fistula (A-V F) (52%), absence of a A-V F (21%), Thomas' shunt infection (8%), infection or extrusion of a previous catheter (19%). The functional survival curve of the C shows the best results for the PC and the worse with the B (Log-Rank test = 6,602, p < 0.037). The main cause of failure was the catheter's extrusion (3 of the 5 failures for the B; 4 of the 6 for the CD). None of the PC was extruded. Infection and inadequate blood flow were equally found in the 3 groups. In our experience, PC give the best results because of the quality of the cuff making a good attachment in the sub-cutaneous tunnel.