Central Venous Catheters

Tunneled, cuffed catheters were developed in 1987 [3]. Since their inception, CVCs have become an access of convenience; easily inserted and available for use within minutes. Maturation or healing time is not necessary; rather, these devices may be used immediately after radiological verification. They are inserted into deep veins such as the jugular, subclavian, or femoral veins and are advanced into the vena cava. They may be placed percutaneously at the bedside thereby eliminating the need for expensive and often unavailable operating room time. CVCs are essential for those patients requiring emergency dialysis or patients who are described as access failure, having used up the vessels required to create a permanent access. These devices can serve as a bridge for new fistulae waiting maturation or as a backup to the fistulas that require ligation due to high output states or steal syndrome [4]. Not only are these catheters readily available, but the survival rates of the CVCs are reported to be 75% at 1 year and 50% at 2 years, thereby allowing them to become an alternate form of long-term access to the arterio-venous fistula and graft [5, 6]. CVCs are used as a permanent access in children, the elderly, morbidly obese, or in diabetic patients whose blood vessels are not suitable for the creation of a permanent, internal, arterio-venous fistula or graft.

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