%0 Journal Article
%T Agitated saline bubble¨Cenhanced ultrasound for the positioning of cuffed, tunneled dialysis catheters in patients with end
%A Jean Jacques Rouby
%A Joao Gabriel Rosa Ramos
%A Juliana Caldas Ribeiro
%A Luis Filipe Miranda Rebelo da Concei£¿£¿o
%A Margarida Maria Dantas Dutra
%A Michel Ribeiro
%A Paulo Benigno Pena Batista
%A Rogerio da Hora Passos
%J The Journal of Vascular Access
%@ 1724-6032
%D 2019
%R 10.1177/1129729818806121
%X In patients with end-stage renal disease, the use of cuffed, tunneled dialysis catheters for hemodialysis has become integral to treatment plans. Fluoroscopy is a widely accepted method for the insertion and positioning of cuffed dialysis catheters, because it is easy to use, accurate and reliable, and has a relatively low incidence of complications. The purpose of our study was to evaluate the feasibility of tunneled hemodialysis catheter placement without the use of fluoroscopy but with a dynamic ultrasound-imaging-based guided technique. From January 2015 to December 2017, we performed an observational prospective cohort study of 56 patients with end-stage renal disease who required tunneled dialysis catheter placement. The overall success rate for ultrasound-guided central access was 100%, with a mean number of 1.16 (¡À0.4) attempts per patient. There were no incidences of guide wire coiling/kinking, carotid puncture, pneumothorax, or catheter malfunction. Catheter flow during dialysis was 286 (¡À38) mL/min. The total number of catheter days was 7451, with a mean of 133£¿days and a range of 46¨C322£¿days. Life table analysis revealed primary patency rates of 100%, 96%, and 53% at 30, 60, and 120£¿days, respectively. Dynamic ultrasound-based visualization of microbubbles in the right atrium is a highly accurate method to detect percutaneous implantation of large-lumen, tunneled, central venous catheters without the need for fluoroscopic guidance technology. Future research should further develop and confirm these initial findings
%K Tunneled dialysis catheters
%K dynamic ultrasound-imaging-based
%K end-stage renal disease
%U https://journals.sagepub.com/doi/full/10.1177/1129729818806121