Hemodialysis catheters: Location is crucial for patency
What role does the location of hemodialysis catheters play regarding the survival of subsequent arteriovenous fistulas?
The answer is a crucial one, as Turkish surgeons found in the present retrospective study (Ozpak B et al, Arteriovenous fistulas ipsilateral to internal jugular catheters for hemodialysis have decreased patency rates; Vascular 2018; doi: 10.1177/1708538118811483).
Approximately 201 patients who initiated dialysis therapy with a hemodialysis catheter had arteriovenous fistulas created on their non-dominant upper extremity after the placement of hemodialysis catheters. The catheters were removed after four consecutive successful dialyses via arteriovenous fistulas.
The authors found that the relative placement of catheters as ipsi- or contralateral had a significant effect on the survival of the arteriovenous fistulas. The contralateral arteriovenous fistula group had a significantly longer survival (778.7 vs. 247.3 days; p < 0.001). Multivariate analyses showed that the relative side of the arteriovenous fistula and hemodialysis catheter, age, and hypertension, were independent predictors of arteriovenous fistula survival.
The ipsilateral localization of catheters and arteriovenous fistulas has a negative effect on arteriovenous fistula survival. The authors suggest always considering the side of catheters / arteriovenous fistulas to improve the survival of the vascular access.
Link to the study: