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Tesio Catheter: Radiologically Guided Placement, Mechanical Performance, and Adequacy of Delivered Dialysis¹

¹ From the Departments of Radiology (S.P., J.M.L., M.W.W., S.R.M., R.K.K., R.L.G.), Surgery (J.M.P.), and Medicine (H.L.S., H.E.I., R.S.O., M.G., B.R.D.), University of California San Francisco, Box 0628, 505 Parnassus Ave, San Francisco, CA 94143-0628. From the 1998 RSNA scientific assembly. Received September 16, 1998; revision requested November 19; final revision received July 2, 1999; accepted July 30. Address reprint requests to S.P. (e-mail: perini@itsa.ucsf.edu).

PURPOSE: Tunneled catheters are an alternative means of vascular access for patients in need of hemodialysis who cannot undergo dialysis through a surgical shunt. This study was undertaken to evaluate the performance of the Tesio dialysis catheter.

MATERIALS AND METHODS: A prospective study of the Tesio catheter was performed. Follow-up data regarding catheter function and adequacy of dialysis were obtained from nine hemodialysis facilities.

RESULTS: Seventy-nine Tesio catheters were placed in 71 patients. Immediate technical success was 99% (78 of 79 catheters). The procedure complication rate was 9% (seven catheters). Only two complications required intervention: one fatal air embolism and one chest wall hematoma. Sixty-seven catheters in 60 patients were followed up for a total of 4,367 catheter days. Overall, catheter-related infection occurred in 9% (six of 67 catheters). Primary catheter patency was 87% at 1 week, 82% at 1 month, 72% at 3 months, and 66% at 6 months. Mean blood flow was 286 mL/min immediately after insertion, 301 mL/min at 3 months, and 306 mL/min at 6 months. Adequate dialysis dose as reflected by a urea reduction ratio of 60 or more or a urea kinetic modeling, or Kt/V, value of 1.2 or more was observed on at least one occasion for 74% and 76% of catheters, respectively.

CONCLUSION: The Tesio catheter is a reasonable means of vascular access for patients who undergo dialysis but are not candidates for surgical shunt placement.

Index terms: Catheters and catheterization, central venous access, 907.1269 • Catheters and catheterization, complications, 81.42, 907.1269 • Catheters and catheterization, technology, 907.1269 • Dialysis, 81.42 • Interventional procedures, 907.1269

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