Tunneled Dialysis Catheter Placement

Many patients with kidney failure require dialysis to take over the work of their kidneys. To set the stage for this treatment, doctors first create direct access to the bloodstream. A dialysis catheter is one such access point in which a flexible tube (catheter) is inserted into a major vein. At Vascular & Interventional Partners in Scottsdale, AZ, our doctors can perform this minimally invasive treatment using safe and advanced techniques.

What Is a Tunneled Dialysis Catheter?

A tunneled dialysis catheter, also called a central venous catheter or central line, is a form of venous access used for hemodialysis. This type of venous access is usually used temporarily or until patients are ready to receive a more permanent access point, like an arteriovenous (AV) fistula or graft. However, they can be a permanent solution for patients without other options.

A tunneled dialysis catheter is placed several inches beneath the skin and into a large vein, preferably an internal jugular vein and subclavian vein. Several inches of the catheter exit just underneath the collar bone and remain outside the body. The catheter has two openings: one to draw blood and the other to return filtered blood into the cardiovascular system. Some catheters have cuffs that help keep the catheter in place.

Tunneled dialysis catheter placement usually takes place in an interventional radiology suite. This procedure is minimally invasive and requires only minor incisions. The first incision is made at the base of the neck and the second below the collarbone. Most patients can be treated using only local anesthesia, and the procedure is over in approximately one hour.

Benefits

If you are unsure whether a tunneled dialysis catheter might be right for you, consider these benefits:

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Allows for immediate dialysis in patients with acute renal failure
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A safe and quick procedure performed on an outpatient basis
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Quick recovery with few side effects
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Easy removal once the catheter is no longer needed
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No need for repeated needle sticks

Learn More About Tunneled Dialysis Catheter Placement

A well-positioned dialysis catheter will last you for as long as required. For the best possible outcome, you must seek treatment from skilled and experienced professionals like the team of five leading interventional radiologists at Vascular & Interventional Partners in Phoenix, AZ.

To learn more about tunneled dialysis catheter placement, contact us or call us today at (480) 435-9100.

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Frequently Asked Questions

Before the procedure, your team will review your medical history, perform a physical exam, and order basic laboratory work. You may also need to undergo a chest X-ray and electrocardiogram.

During the procedure, you will be lying on an operating table that is slightly tilted to a 15-30 degree incline. You will be given intravenous (IV) sedation or general anesthesia if necessary. You will wear a hospital gown and be covered in surgical drapes.

Your provider will cleanse and numb the treatment area in the lower neck. They will then make a small incision to insert a guidewire into the interior jugular vein and towards the vena cava. Your provider will then make a second incision below your collarbone on the same side as your first incision. They will create a tunnel to pass a flexible catheter to the first incision. The catheter is then passed over the guidewire and into the veins with the help of real-time X-ray image guidance.

Once the catheter is in place, the guidewire is removed. One end of the catheter will remain inside major veins, while the other end will stick out of the second incision site. Your doctor will make sure blood is circulating in your catheter before securing the catheter with stitches for cuffless catheters. You will need a post-procedure chest X-ray to confirm that the catheter is correctly placed.

The risks of using a dialysis catheter include:

Possible post-treatment infections, thrombosis, and central vein stenosis
Can interfere with normal activities, like swimming and lifting
Unable to maintain adequate blood flow for optimal waste removal

The risks of tunneled dialysis catheters can outweigh the benefits for long-term use. This is why they may not be recommended as a permanent solution.

Since dialysis catheter placement is an outpatient procedure in most cases, you will be discharged on the same day of your procedure. It is a good idea to arrange for someone to drive you back home and help you with daily chores in the first few days of your recovery. You will be able to receive dialysis treatment immediately.

Some pain and swelling at the treatment site can be expected in the first few days of your recovery. These can be managed at home with pain medication and cold compresses as prescribed by your doctor.

You will need to keep your catheter dressing clean and look for any signs of infection, like redness, swelling, and pus drainage around the catheter exit site. You may shower on the second or third day after your procedure and start with light activity. Avoid lifting anything heavy until your incisions are completely healed, and follow your doctor’s instructions on the proper way to care for your catheter.

If you have acute or chronic kidney failure, a tunneled dialysis catheter makes it possible for you to receive dialysis quickly. Kidney failure is when 85 to 90% of your kidney function is gone and you need dialysis to survive.

For most patients, a tunneled dialysis catheter is a temporary solution until they can get something more permanent, e.g., a kidney transplant, AV fistula, or graft. While some patients can benefit from a permanent tunneled dialysis catheter, catheters come with significant risks and are not the preferred type of access point.

Patients who need to keep their tunneled dialysis catheter for a long time or permanently are usually those with a failed AV access point or for whom AV fistula surgery is risky.

Tunneled Dialysis Catheter Placement