Observational studyBMC nephrology2025
Fluoroscopy-free insertion of tunneled hemodialysis catheters: ensuring safety and precision - a retrospective observational study.
Observational study in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundReliable vascular access is essential for hemodialysis. While arteriovenous fistulas are preferred for long-term use, tunneled hemodialysis catheters (TDCs) remain necessary, especially in urgent settings or when fistula creation is not feasible. Fluoroscopy is traditionally used to confirm catheter tip placement, but limited access and higher costs can be barriers. This study evaluated the safety and feasibility of fluoroscopy-free TDC placement using ultrasound and anatomical landmarks.
methodsWe performed a retrospective analysis of 266 TDC insertions between 2018 and 2023 at a single center. All procedures were ultrasound-guided with landmark-based planning. Post-procedural imaging verified tip position, and any malposition prompted immediate repositioning. Data collected included insertion site, patient demographics, incident vs. prevalent dialysis status, complications, and need for repositioning.
resultsThe median patient age was 65 ± 15 years, with 58% male. Most catheters were placed via the internal jugular vein (91.7%; 223 right, 21 left). Femoral access was used in 7.9% and subclavian in one case. Bleeding complications were infrequent and occurred in 4% of cases. There was also a single instance of inadvertent carotid artery puncture, successfully managed without major intervention. Tip repositioning was required in 11% of internal jugular placements; repositioning assessment was not applicable for femoral access. Comparative analysis showed no significant differences in bleeding rates or need for repositioning between right and left internal jugular vein insertions.
conclusionsUltrasound and landmark-guided TDC placement without fluoroscopy proved safe and effective, with low complication rates and reliable function. These findings support fluoroscopy-free approaches as practical alternatives, especially in settings with limited imaging access. CLINICAL TRIAL NUMBER: Not applicable.
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