Nontunneled catheter: Short-term central venous catheter placed percutaneously into central veins of chest or abdomen
Catheter of choice in management of acute medical conditions
Typical dwell time of days to weeks
Not appropriate for outpatient setting
Tunneled catheter: Intermediate- or long-term venous catheter introduced through subcutaneous tunnel into central veins of chest or abdomen
Subcutaneous tunnel forms natural infection barrier
Dacron cuff on catheter promotes tissue ingrowth
Secures catheter within tunnel
Enhances natural infection barrier of tunnel
Various tunneled catheters for range of indications
HD catheter
Pheresis catheter
Tunneled central venous catheter
Hickman catheter
Broviac catheter
Groshong catheter
Types of catheters
End-hole catheter
Most common type of catheter
Tip may be trimmed to required length
Typical use for tunneled central venous catheters
Staggered-tip catheter
Designed to allow simultaneous aspiration/infusion with minimal mixing
Cannot trim tip
Typical use is for temporary HD or plasmapheresis
Valve-tip catheter
Valve opens inward for aspiration/outward for infusion
Cannot trim tip
Adaptor allows external portion of catheter to be trimmed to appropriate length
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things to Do
Things to Avoid
Management of Nontunneled Catheter-Specific Complications
Management of Impaired Tunneled Catheters
OUTCOMES
Complications
Expected Outcomes
Selected References
Forneris G et al: Ultrasound in central venous access for hemodialysis. J Vasc Access. 22(1_suppl):97-105, 2021
Agarwal AK et al: Avoiding problems in tunneled dialysis catheter placement. Semin Dial. 32(6):535-40, 2019
Ibeas-Lopez J: New technology: heparin and antimicrobial-coated catheters. J Vasc Access. 16 Suppl 9:S48-53, 2015
Clark EG et al: Temporary hemodialysis catheters: recent advances. Kidney Int. 86(5):888-95, 2014
Hacker RI et al: Fibrin sheath angioplasty: a technique to prevent superior vena cava stenosis secondary to dialysis catheters. Int J Angiol. 21(3):129-34, 2012
Patel IJ et al: Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol. 23(6):727-36, 2012
Vats HS: Complications of catheters: tunneled and nontunneled. Adv Chronic Kidney Dis. 19(3):188-94, 2012
Bhutta ST et al: Evaluation and management of central venous access complications. Tech Vasc Interv Radiol. 14(4):217-24, 2011
Chung HY et al: Principles of non-tunneled central venous access. Tech Vasc Interv Radiol. 14(4):186-91, 2011
Ni N et al: Association between disruption of fibrin sheaths using percutaneous transluminal angioplasty balloons and late onset of central venous stenosis. Cardiovasc Intervent Radiol. 34(1):114-9, 2011
Haas B et al: Large-bore tunneled central venous catheter insertion in patients with coagulopathy. J Vasc Interv Radiol. 21(2):212-7, 2010
Nakae H et al: Catheter-related infections via temporary vascular access catheters: a randomized prospective study. Artif Organs. 34(3):E72-6, 2010
Vanholder R et al: Catheter-related blood stream infections (CRBSI): a European view. Nephrol Dial Transplant. 25(6):1753-6, 2010
Banerjee S: Dialysis catheters and their common complications: an update. ScientificWorldJournal. 9:1294-9, 2009
Chan MR et al: Tunneled dialysis catheters: recent trends and future directions. Adv Chronic Kidney Dis. 16(5):386-95, 2009
Coryell L et al: The case for primary placement of tunneled hemodialysis catheters in acute kidney injury. J Vasc Interv Radiol. 20(12):1578-81; quiz 1582, 2009
Pittiruti M et al: ESPEN guidelines on parenteral nutrition: central venous catheters (access, care, diagnosis and therapy of complications). Clin Nutr. 28(4):365-77, 2009
Worth LJ et al: Infective and thrombotic complications of central venous catheters in patients with hematological malignancy: prospective evaluation of nontunneled devices. Support Care Cancer. 17(7):811-8, 2009
Ash SR: Advances in tunneled central venous catheters for dialysis: design and performance. Semin Dial. 21(6):504-15, 2008
Ausserhofer D et al: [Care of the non-tunneled central venous catheter. Literature search on disinfectants, dressings and intervals between dressing changes.] Pflege Z. 61(8):457-62, 2008
Hwang FR et al: Tunneled infusion catheter breakage: frequency and repair kit outcomes. J Vasc Interv Radiol. 19(2 Pt 1):201-6, 2008
Ward E et al: Tunneled central venous catheter malpositioning. Cardiovasc Intervent Radiol. 31(3):673, 2008
Castelli GP et al: Central venous catheter replacement in the ICU: new site versus guidewire exchange. Minerva Anestesiol. 73(5):267-73, 2007
Toro JJ et al: Patterns of use of vascular access devices in patients undergoing hematopoietic stem cell transplantation: results of an international survey. Support Care Cancer. 15(12):1375-83, 2007
Chiou PF et al: Antibiotic lock technique reduces the incidence of temporary catheter-related infections. Clin Nephrol. 65(6):419-22, 2006
Maki DG et al: The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc. 81(9):1159-71, 2006
Warren DK et al: A multicenter intervention to prevent catheter-associated bloodstream infections. Infect Control Hosp Epidemiol. 27(7):662-9, 2006
Ponikvar R et al: Temporary hemodialysis catheters as a long-term vascular access in chronic hemodialysis patients. Ther Apher Dial. 9(3):250-3, 2005
Abdelkefi A et al: [Infectious complications related to non-tunneled central venous catheters in immunocompromised patients: prospective study about 210 cases.] Ann Fr Anesth Reanim. 22(9):773-7, 2003
Lewis CA et al: Quality improvement guidelines for central venous access. J Vasc Interv Radiol. 14(9 Pt 2):S231-5, 2003
III. NKF-K/DOQI clinical practice guidelines for vascular access: update 2000. Am J Kidney Dis. 37(1 Suppl 1):S137-81, 2001
Cicconi S et al: Non-tunneled central venous catheters in adult stem cell transplantation recipients: an effective option. J Vasc Access. 2(4):168-74, 2001
Abidi SM et al: Factors influencing function of temporary dialysis catheters. Clin Nephrol. 53(3):199-205, 2000
Oliver MJ et al: Risk of bacteremia from temporary hemodialysis catheters by site of insertion and duration of use: a prospective study. Kidney Int. 58(6):2543-5, 2000
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Procedure
Post Procedure
Outcomes
TERMINOLOGY
Synonyms
Nontunneled catheters
Temporary central venous catheter
Temporary dialysis catheter
Central venous catheter
Tunneled catheters
Tunneled hemodialysis (HD) catheter
Tunneled central venous catheter
Permanent catheter
Definitions
Nontunneled catheter: Short-term central venous catheter placed percutaneously into central veins of chest or abdomen
Catheter of choice in management of acute medical conditions
Typical dwell time of days to weeks
Not appropriate for outpatient setting
Tunneled catheter: Intermediate- or long-term venous catheter introduced through subcutaneous tunnel into central veins of chest or abdomen
Subcutaneous tunnel forms natural infection barrier
Dacron cuff on catheter promotes tissue ingrowth
Secures catheter within tunnel
Enhances natural infection barrier of tunnel
Various tunneled catheters for range of indications
HD catheter
Pheresis catheter
Tunneled central venous catheter
Hickman catheter
Broviac catheter
Groshong catheter
Types of catheters
End-hole catheter
Most common type of catheter
Tip may be trimmed to required length
Typical use for tunneled central venous catheters
Staggered-tip catheter
Designed to allow simultaneous aspiration/infusion with minimal mixing
Cannot trim tip
Typical use is for temporary HD or plasmapheresis
Valve-tip catheter
Valve opens inward for aspiration/outward for infusion
Cannot trim tip
Adaptor allows external portion of catheter to be trimmed to appropriate length
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things to Do
Things to Avoid
Management of Nontunneled Catheter-Specific Complications
Management of Impaired Tunneled Catheters
OUTCOMES
Complications
Expected Outcomes
Selected References
Forneris G et al: Ultrasound in central venous access for hemodialysis. J Vasc Access. 22(1_suppl):97-105, 2021
Agarwal AK et al: Avoiding problems in tunneled dialysis catheter placement. Semin Dial. 32(6):535-40, 2019
Ibeas-Lopez J: New technology: heparin and antimicrobial-coated catheters. J Vasc Access. 16 Suppl 9:S48-53, 2015
Clark EG et al: Temporary hemodialysis catheters: recent advances. Kidney Int. 86(5):888-95, 2014
Hacker RI et al: Fibrin sheath angioplasty: a technique to prevent superior vena cava stenosis secondary to dialysis catheters. Int J Angiol. 21(3):129-34, 2012
Patel IJ et al: Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol. 23(6):727-36, 2012
Vats HS: Complications of catheters: tunneled and nontunneled. Adv Chronic Kidney Dis. 19(3):188-94, 2012
Bhutta ST et al: Evaluation and management of central venous access complications. Tech Vasc Interv Radiol. 14(4):217-24, 2011
Chung HY et al: Principles of non-tunneled central venous access. Tech Vasc Interv Radiol. 14(4):186-91, 2011
Ni N et al: Association between disruption of fibrin sheaths using percutaneous transluminal angioplasty balloons and late onset of central venous stenosis. Cardiovasc Intervent Radiol. 34(1):114-9, 2011
Haas B et al: Large-bore tunneled central venous catheter insertion in patients with coagulopathy. J Vasc Interv Radiol. 21(2):212-7, 2010
Nakae H et al: Catheter-related infections via temporary vascular access catheters: a randomized prospective study. Artif Organs. 34(3):E72-6, 2010
Vanholder R et al: Catheter-related blood stream infections (CRBSI): a European view. Nephrol Dial Transplant. 25(6):1753-6, 2010
Banerjee S: Dialysis catheters and their common complications: an update. ScientificWorldJournal. 9:1294-9, 2009
Chan MR et al: Tunneled dialysis catheters: recent trends and future directions. Adv Chronic Kidney Dis. 16(5):386-95, 2009
Coryell L et al: The case for primary placement of tunneled hemodialysis catheters in acute kidney injury. J Vasc Interv Radiol. 20(12):1578-81; quiz 1582, 2009
Pittiruti M et al: ESPEN guidelines on parenteral nutrition: central venous catheters (access, care, diagnosis and therapy of complications). Clin Nutr. 28(4):365-77, 2009
Worth LJ et al: Infective and thrombotic complications of central venous catheters in patients with hematological malignancy: prospective evaluation of nontunneled devices. Support Care Cancer. 17(7):811-8, 2009
Ash SR: Advances in tunneled central venous catheters for dialysis: design and performance. Semin Dial. 21(6):504-15, 2008
Ausserhofer D et al: [Care of the non-tunneled central venous catheter. Literature search on disinfectants, dressings and intervals between dressing changes.] Pflege Z. 61(8):457-62, 2008
Hwang FR et al: Tunneled infusion catheter breakage: frequency and repair kit outcomes. J Vasc Interv Radiol. 19(2 Pt 1):201-6, 2008
Ward E et al: Tunneled central venous catheter malpositioning. Cardiovasc Intervent Radiol. 31(3):673, 2008
Castelli GP et al: Central venous catheter replacement in the ICU: new site versus guidewire exchange. Minerva Anestesiol. 73(5):267-73, 2007
Toro JJ et al: Patterns of use of vascular access devices in patients undergoing hematopoietic stem cell transplantation: results of an international survey. Support Care Cancer. 15(12):1375-83, 2007
Chiou PF et al: Antibiotic lock technique reduces the incidence of temporary catheter-related infections. Clin Nephrol. 65(6):419-22, 2006
Maki DG et al: The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc. 81(9):1159-71, 2006
Warren DK et al: A multicenter intervention to prevent catheter-associated bloodstream infections. Infect Control Hosp Epidemiol. 27(7):662-9, 2006
Ponikvar R et al: Temporary hemodialysis catheters as a long-term vascular access in chronic hemodialysis patients. Ther Apher Dial. 9(3):250-3, 2005
Abdelkefi A et al: [Infectious complications related to non-tunneled central venous catheters in immunocompromised patients: prospective study about 210 cases.] Ann Fr Anesth Reanim. 22(9):773-7, 2003
Lewis CA et al: Quality improvement guidelines for central venous access. J Vasc Interv Radiol. 14(9 Pt 2):S231-5, 2003
III. NKF-K/DOQI clinical practice guidelines for vascular access: update 2000. Am J Kidney Dis. 37(1 Suppl 1):S137-81, 2001
Cicconi S et al: Non-tunneled central venous catheters in adult stem cell transplantation recipients: an effective option. J Vasc Access. 2(4):168-74, 2001
Abidi SM et al: Factors influencing function of temporary dialysis catheters. Clin Nephrol. 53(3):199-205, 2000
Oliver MJ et al: Risk of bacteremia from temporary hemodialysis catheters by site of insertion and duration of use: a prospective study. Kidney Int. 58(6):2543-5, 2000
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