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The patient population for this study is individuals requiring high-flow polyurethane tunneled dialysis catheters (TDC) for hemodialysis access. The primary objective of this study is to compare outcomes of participants who undergo left internal jugular placement of a split-tip versus a step-tip versus symmetric tip catheter. This study will review and compare the complication rate and function of the three catheter designs.
The patient population for this study is individuals requiring high-flow polyurethane tunneled dialysis catheters (TDC) for hemodialysis access. The primary objective of this study is to compare outcomes of participants who undergo left internal jugular placement of a split-tip versus a step-tip versus symmetric tip catheter. Participants will be randomized to receive a split-tip, step-tip or symmetric tip catheter in a 1:1:1 ratio. All participants will be followed per their referring physician's standard of care. Information regarding any patient complications will be obtained from Dr. Allon's dialysis patient database (Vascular Access in Hemodialysis Patients, IRB # X980813005). This study will review and compare the complication rate and function of the three catheter designs. There are no studies to our knowledge that compared catheter designs placed specifically via the left internal jugular vein. The investigators hypothesize that because the left internal jugular vein is anatomically more complex than the right one, tunneled dialysis catheters with split-tip design may perform sub-optimally, compared to step-tip and symmetric tip designs, when placed via the left internal jugular vein. If this hypothesis is true, the results of the study may influence future clinical practice and reduce the rates of replacement of catheters placed through the left internal jugular vein, resulting in better patient care and significant cost-savings.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Tunneled dialysis Split-tip catheter | Active Comparator | High-flow tunneled Split-tip catheter for hemodialysis will be inserted by standard interventional technique |
|
| Tunneled dialysis Step-tip catheter | Active Comparator | High-flow tunneled Step-tip catheter for hemodialysis will be inserted by standard interventional technique |
|
| Tunneled dialysis Symmetric tip catheter | Active Comparator | High-flow tunneled Symmetric tip catheter for hemodialysis will be inserted by standard interventional technique |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tunneled dialysis catheter placement. | Device | Placement of high-flow tunneled catheter for hemodialysis |
|
| Measure | Description | Time Frame |
|---|---|---|
| Complication rate | 1 month complication rate of left internal jugular vein dialysis catheters | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Catheter dysfunction | 1 month complication rate of left internal jugular vein dialysis catheters | 1 months |
| Catheter dysfunction | 3 months complication rate of left internal jugular vein dialysis catheters |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Akabama at Birmingham | Birmingham | Alabama | 35249 | United States |
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| ID | Term |
|---|---|
| D004194 | Disease |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| 3 months |
| Catheter dysfunction | 6 months complication rate of left internal jugular vein dialysis catheters | 6 months |
| Complication rate | 3 months complication rate of left internal jugular vein dialysis catheters | 3 months |
| Complication rate | 6 months complication rate of left internal jugular vein dialysis catheters | 6 months |