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Comparison of Clinical Performance Between Two Types of Symmetric-Tip Hemodialysis Catheters: A Single-Centre, Randomized Trial

  • Clinical Investigation
  • Venous Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To compare the clinical performance of a newly designed, symmetric-tip Arrow–Clark™ VectorFlow® tunnelled haemodialysis catheter, with a Glidepath™, symmetric-tip tunnelled haemodialysis catheter.

Material and Methods

From November 2018 to October 2020, patients with End-Stage Renal Disease requiring a de novo tunnelled catheter for hemodialysis, were randomized to Vectorflow® (n = 50) or to Glidepath™ catheter (n = 48). The primary outcome was catheter patency at one year following catheter insertion. Catheter failure was defined as the removal of the catheter due to infectious complications, or low blood flow rate by intraluminal thrombosis or fibrin sheath occlusion. Secondary outcomes were blood flow rate, fractional urea clearance and urea reduction ratio during dialysis.

Results

Demographic characteristics were not different between the two groups. At three months and on the one-year endpoint the patency rates with the Vectorflow® catheter were 95.83% and 83.33% respectively, compared to 93.02% at both endpoints with the Glidepath™ catheter (P = 0.27). Catheter failure to infectious complications or low blood flow rate was similar in both groups. Catheter blood flow rate reached the threshold of 300 ml/min at all time points for both catheters. All patients had a high mean fractional urea clearance (1.6–1.7).

Conclusions

The catheter patency rate was not significantly different in patients with a VectorFlow® or a Glidepath™ catheter. Both catheters presented satisfactory dialysis adequacy over one year.

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Abbreviations

CIF:

Cumulative incidence function

CRBSI:

Catheter-related bloodstream infections

CVC:

Central venous catheter

ESRD:

End-stage renal disease

IDSA:

Infectious disease society of America

INR:

International normalized ratio

KDOQI:

Kidney dialysis outcomes quality initiative

Kt/V:

Fractional urea clearance

Qb:

Blood flow rate

RRT:

Renal replacement therapy

URR:

Urea reduction ratio

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Nephrology, University Hospitals KU Leuven, Leuven, Belgium

    Pauline Braet, Kathleen Claes & Katrien De Vusser

  2. Department of Radiology, AZ Sint-Jan Hospital Brugge, Brugge, Belgium

    Andries Van Holsbeeck

  3. Department of Radiology, AZ Sint-Lucas Hospital Brugge, Brugge, Belgium

    Andries Van Holsbeeck

  4. Department of Radiology, University Hospitals KU Leuven, Herestraat 49, 3000, Leuven, Belgium

    Pieter-Jan Buyck & Geert Maleux

  5. Department of Public Health and Primary Care, Leuven Biostatistics and Statistical Bioinformatics Centre, Leuven, Belgium

    Annouschka Laenen

Authors
  1. Pauline Braet
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  2. Andries Van Holsbeeck
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  3. Pieter-Jan Buyck
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  4. Annouschka Laenen
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  5. Kathleen Claes
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  6. Katrien De Vusser
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  7. Geert Maleux
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Contributions

All authors contributed to the writing of the text and they all read and approved the final manuscript.

Corresponding author

Correspondence to Geert Maleux.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Research Ethics Committee of the University Hospitals Leuven granted favourable advice for this study (S-61271).

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Informed consent was obtained from all individual participants included in the study.

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Consent for publication was obtained for all individual person’s data included in the study.

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Braet, P., Van Holsbeeck, A., Buyck, PJ. et al. Comparison of Clinical Performance Between Two Types of Symmetric-Tip Hemodialysis Catheters: A Single-Centre, Randomized Trial. Cardiovasc Intervent Radiol 46, 983–990 (2023). https://doi.org/10.1007/s00270-023-03476-0

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  • DOI: https://doi.org/10.1007/s00270-023-03476-0

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