Patients with end-stage renal disease (CRF) treated with hemodialysis (HD) are increasing annually worldwide. Their quality of life to a large extent depends on the quality of their hemodialysis treatment. One of the main factors for this is the type of the used vessel access.
In practice, three main types of vascular access are used – arterio-venous fistula, arterio-venous prosthesis and central venous catheter – which in turn is divided into temporary and tunneled.
Temporary hemodialysis catheters were introduced in the mid-1970s, while tunneled catheters entered relatively later. Temporary vascular access is a consequence of emergencies through catheterization of large venous vessels. It is applicable in acute renal failure and is undesirable for chroniodialysis. Temporary catheters should be replaced by Permanent Tunneled Catheters.
The implantation of permanent tunneled catheters is performed by highly specialized physicians under constant ultrasound, X-ray or angiographic control during or after the procedure. They are most often implanted in the right atrium and are a complex medical procedure.
Permanent tunneled catheters are recommended in adult patients, such as those with cardiovascular disease, diabetics, cancer patients or in cases where prolonged stay of hemodialysis treatment is not expected.