When an AV fistula is not possible or not yet mature, a tunneled hemodialysis catheter enables hemodialysis through a central venous access. The catheter is placed through the jugular vein into the right atrium — through a subcutaneous tunnel that significantly reduces infection risk.
Hemodialysis Catheter Implantation and Management – IRZ Zurich
What We Offer
- Implantation of new tunneled hemodialysis catheters under ultrasound and fluoroscopic guidance
- Catheter exchange for malfunction or suspected infection
- Treatment of fibrin sheaths through thrombolysis or stripping
- Diagnostic workup for catheter dysfunction
FAQ
Tunneled catheters can remain in situ for years, provided they are properly maintained and complication-free. Regular flushing with heparin or trisodium citrate between dialysis sessions is important.
A fibrin sheath is a coating of the body’s own protein that forms around the dialysis catheter, reducing blood flow. It can be treated by catheter-side thrombolysis (infusing a lytic agent directly into the catheter) or by mechanical stripping (pulling off the fibrin sheath with a catheter).
Fever, redness or discharge at the catheter exit site, declining blood flow, or back-pressure during dialysis are warning signs. Please inform the dialysis center immediately.
After tunneled hemodialysis catheter implantation, mild pain at the insertion site and pressure sensation in the neck for 1–2 days are normal.
Please contact us or your dialysis center immediately if you experience:
⚠ Redness, swelling, or purulent discharge at the catheter site or tunnel tract (sign of infection — report immediately)
⚠ Fever above 38.0°C (100.4°F) with chills (possible catheter sepsis — urgent)
⚠ Sudden shortness of breath or chest pain after implantation (very rare pneumothorax)
Scientific References
- Dariushnia SR et al. Quality improvement guidelines for tunneled hemodialysis catheters. J Vasc Interv Radiol. 2016;27(1):67–74.
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