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| Journal of Vascular Access 2000; 1: 51 - 53 |
| Slow maturation of arterio-venous fistula in seven uremic patients: use of Ash Split Cath® as temporary, prolonged vascular access |
P.A. Conz1, G. La Greca2
1Department of Nephrology and Dialysis, Monselice Hospital, Monselice, Padova - Italy
2Department of Nephrology and Dialysis, S. Bortolo Hospital, Vicenza - Italy
ABSTRACT
The temporary vascular access is the essential condition required to perfrom hemodialysis in uremic patients in the absence of a permanent and utilizable vascular access. The cannulation of a central vein with a dual lumen catheter may be useful when a few weeks are required for the maturation of AVF. Longer times for AVF maturation (such as in diabetic patients and in aged patients) impose the use of a tunnelled catheter such as Tesio Catheter or Hickman Catheter which lead to minor complications and more efficient dialysis treatment. The Ash Split Cath®, a recently introduced chronic hemodialysis catheter, provides dialysis via a transcutaneous portion containing a 14 French cylindrical shaped catheter with D-shaped lumens and a dacron cuff. Due to the slow maturing of AVF, in our Department the Ash Split Cath has been used in 7 uremic patients (3 males and 4 females) who required hemodialysis. The cannulation of the internal jugular vein was performed by an ultrasound assisted technique and the correct catheter position was verified by standard chest X-rays. The average blood flowrates were 250 ml/min, and the mean KT/V calculated in all patients one month after the beginning of the dialytic therapy was 1.09 ± 0.02. In six patients the catheter was utilized for at least 4 months, in one patient for 8 months. The devices were easily removed when the patient’s AVF was functional and usable. We found that the use of the Ash Split Cath as a temporary, prolonged vascular access in uremic patients was op-timal allowing for flexibility in organizing the dialysis treatment schedule and in yielding a good performance in the initial dialysis therapy. Moreover, this device allows, in these patients, a satisfactory dialysis efficiency.
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