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P1345CATHETER FAILURE AND MORTALITY IN HEMODIALYSIS PATIENTS WITH THE TUNNELLED-CUFFED CATHERTER TIP POSITIONED IN THE INFERIOR VENA CAVA


 
 
 For patients with multiple central vein obstruction (CVO) and exhausted all options for arteriovenous accesses, how to establish a new effective vascular access is an urgent problem, and the key point to solve this problem is where to locate the tip of catheter. This study focused on these patients and investigated the safety and efficient of tunnelled cuffed catheter (TCC) with the tip placed in the inferior vena cava (IVC).
 
 
 
 Thirty-three maintenance haemodialysis patients with vascular access malfunction presented to West China Hospital of Sichuan University from March 2013 to December 2016 were included in this retrospective study and followed up until their catheter failure or death or until June 30, 2019. The short-term efficacy and safety of the procedure placing TCC tip in IVC were observed. The survival rates of TCC with catheter tip in IVC and patients were analysed.
 
 
 
 All thirty-three patients achieved adequate blood flow to complete the first session of haemodialysis after catheterization procedure and no obvious complications, such haemorrhage, arrhythmia and pulmonary embolism. The mean survival time of the TCC with catheter tip in IVC was 58.5 (95% CI 48.8–63.4) months by Kaplan–Meier analysis. The survival rates of TCC with catheter tip in IVC were 87, 83, 75, 71% in 1, 2, 3, 4 years, respectively. The highest incidence of catheter dysfunction was at 12 months after catheterization. The mean survival time of patients was 56.2 (95% CI 46.9–65.4) months by Kaplan–Meier analysis. The patient survival rates were 88, 82, 70, 67 % in 1, 2, 3, 4 years, respectively. The highest mortality was at 12 months after catheterization.
 
 
 
 Our study suggested that placement of the tunnelled-cuffed catheter tip in the IVC was safety and efficacy in the end-stage haemodialysis patients who has exhausted vascular resources with CVO. The TCC with tip in the IVC was feasible to be a long-term vascular access for these patients.
