ArticleThe journal of vascular access2026
Stylet-protected guidewire-exchange for infected tunneled hemodialysis catheters: Outcomes from a single-center retrospective study.
Article in The journal of vascular access, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCatheter-related bloodstream infections (CRBSIs) are the main complications associated with the use of permanent central venous catheters (CVCs). However, standardized management protocols for infected tunneled CVCs remain heterogeneous. We present an innovative stylet-protected guidewire-exchange technique designed to minimize contamination and preserve vascular access sites.
methodsWe performed a retrospective, observational, single-center study of infected tunneled CVC replacement at the Nephrology Unit of Policlinico A. Gemelli Foundation (Rome) from January 2019 to June 2024. Follow-up ranged from 1 to 4 years. The primary endpoint was infection-free survival, defined as time to relapse (recurrent CRBSI with the same pathogen) or reinfection (a different pathogen).
resultsA total of 99 CVC exchanges were performed in 99 patients (M 50.5%, F 49.5%; median age: 72 years, IQR 62-78.5). To assess the safety of the technique, guidewire cultures were obtained, confirming persistence of the initial CRBSI pathogen. Despite positive guidewire cultures, relapse by the same pathogen occurred in only 2% of cases: one
conclusionsThis stylet-protected guidewire-exchange demonstrated excellent infection-free survival, including infections caused by high-risk pathogens such as
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