• Rosilene Motta Elias, Sonia Cristina da Silva Makida, Hugo Abensur, Manuel Carlos Martins Castro, Rosa Maria Affonso Moysés, Benedito Jorge Pereira, Rodrigo Bueno de Oliveira, Cláudio Luders, and João Egidio Romão.
• Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil. rosilenemotta@hotmail.com
• J Vasc Access. 2010 Apr 1;11(2):138-42.

BackgroundThe tunneled cuffed catheter (TCC) is used as a bridge access for hemodialysis. Few prospective studies have been designed to evaluate conversion from non-tunneled to TCC without the use of fluoroscopy when performed by nephrologists.MethodsWe performed an observational prospective cohort in incident patients receiving hemodialysis through a non-tunneled right jugular vein catheter.Results130 procedures were performed in 122 patients (51+/-18 years). The success rate was 100%. There was a total of 26,546 catheter days. Ninety-one of the 130 catheters were removed during the study period. Life table analysis revealed primary patency rates of 92%, 82%, and 68% at 30, 60, and 120 days, respectively. Infection requiring catheter removal occurred at a frequency of 0.09 per 100 catheter days. Catheter malfunction requiring intervention occurred at a rate of 0.03 per 100 catheter days. Hypertension and duration of existing non-tunneled catheter of less than 2 weeks were independently associated with better TCC survival.ConclusionThe conversion from non-tunneled to TCC performed by nephrologists and without fluoroscopy may be safe by using the internal right jugular vein. The ideal time to do this procedure is within less than 2 weeks of existing non-tunneled catheter.

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