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Article Type

Original Study

Abstract

Background Vascular access (VA) remains the cornerstone in HD patients. The survival of the patients becomes risky if approaches like arteriovenous fistulae, grafts, and thoracic tunneled central catheters are used with no benefits. The options become limited to transplantation, dialysis through the peritoneum, and catheter insertion translumbarally or femorally, which in some cases is the only available approach. Methods We are discussing our experience from Mataria Teaching Hospital with 17 patients; in those patients, all the vascular procedures were used with no benefits. We could not perform other options like transplantation or peritoneal dialysis. Hence, we chose femoral tunneled catheters (FTC) permanent VA. The follow-up period ranged between 2 and 14 months, with a mean period of 10 months. The mean age of the patients was 55 ( 40–70) years. In 10 patients, a Permcath was inserted, and in the other seven, a Duraflow was inserted. All patients were administered warfarin after bridging with low molecular weight heparin to avoid occurring of catheter thrombosis. Aseptic procedures and personal hygiene were followed. Result Two patients died at 5 and 12 months, correspondingly, with a functional catheter, owing to causes other than related to the FTC. In one patient, accidental pulling of the catheter occurred, so the site of the catheter was changed at 5 months. One catheter was altered because fl ow became inadequate after 8 months. No patients presented with deep vein thrombosis or late hemorrhage. In one patient, the catheter functioned for 14 months after insertion. In four patients, the catheter was removed, after 2, 3, 4, and 14 months, correspondingly, as they developed catheter-related septicemia. In two patients, the catheter was removed owing to perforation after 2 months.

Keywords

Catheter, dialysis, vascular access

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