Insertion of Permanent Catheter / Tunnelled Dialysis Catheter
What is a Tunnelled Dialysis Catheter?
A tunnelled dialysis catheter is a soft, flexible tube inserted into a large vein, typically in the neck (internal jugular vein) or groin (femoral vein), providing reliable vascular access for haemodialysis in patients with chronic kidney disease (CKD) who cannot undergo arteriovenous fistula or graft creation.
Why is a Tunnelled Dialysis Catheter Needed?
For patients undergoing haemodialysis, a permanent or tunnelled catheter may be required when fistula or graft formation is not feasible. The catheter allows blood to be efficiently filtered by the haemodialysis machine and is often used until a more permanent vascular access is available.
How is a Tunnelled Dialysis Catheter Placed?
- The catheter is inserted into a large vein, typically in the neck or groin.
- It is tunnelled under the skin to emerge at the chest or thigh.
- A cuff is placed under the skin to promote tissue growth, securing the catheter and reducing infection risks.
- The catheter has two lumens: one for drawing blood for filtration and the other for returning filtered blood back to the body.
Types of Tunnelled Dialysis Catheters
✅ Temporary Catheter – Used for short-term dialysis access when immediate haemodialysis is needed.
✅ Long-Term Catheter – Used when fistula or graft is not an option or while waiting for a permanent vascular access.
Advantages of a Tunnelled Dialysis Catheter
✔ Immediate Haemodialysis Access – No need to wait for maturation, unlike a fistula. ✔ Minimally Invasive Procedure – Inserted through a vein without surgery. ✔ Reliable Blood Flow – Ensures efficient dialysis sessions. ✔ Can Be Used Long-Term – Suitable when other vascular access options are not viable.
Risks & Considerations
While effective, a tunnelled catheter may have potential risks: ⚠ Infection Risk – Requires strict hygiene and care to prevent infections. ⚠ Clotting & Blockage – Regular maintenance with flushing may be needed. ⚠ Lower Blood Flow Rate – May not be as efficient as an arteriovenous fistula.
Conclusion
A tunnelled dialysis catheter is a vital solution for patients requiring long-term haemodialysis when other vascular access options are not possible. With proper care and monitoring, it serves as an effective bridge until a more permanent access can be established.
