Double Lumen Catheter A V Graft A V Fistula

Double Lumen Catheter

The double lumen catheter may either be temporary or long term. Those used long term are generally cuffed, tunneled under the skin, and surgically placed. They are generally placed when dialysis is needed emergently - either when the patient is referred late or when the permanent av access fails, and the patient is too unstable to have it revised until after an emergency treatment.

These catheters may develop serious infections, or may thrombose (clot) and fail. They can stimulate the clotting of the vein they are placed in. They are generally placed either into the subclavian vein or the jugular vein. Occasionally, they are temporarily placed in the femoral vein. The subclavian vein catheters are most likely associated with venous thrombosis or clotting.

When the subclavian vein clots, it makes it very difficult for the patient to sustain an a v graft or fistula. Therefore, these catheters should be avoided whenever possible in lieu of placing a more permanent access. Ideally, the patient is referred early to the surgeon for placement of an a v fistula. It is critical that veins in patients at high risk to develop renal failure are preserved to maximize the chance for a functioning a v fistula.

• Avoiding Double Lumen Catheters

A V Grafts

The AV graft uses synthetic material such as a type of teflon (ptfe), and connects an artery and vein in the arm. It is generally placed a few weeks prior to use, and takes around two weeks to mature. Its major complications are failure, stenosis and infection.

Stenosis at the outflow tract may first present as increased venous pressure. If unopened by angioplasty, this stenosis progresses until the vessel is completely blocked.

AV graft survival is around 1.5 years, considerably shorter than AV fistulae.

A V Fistulae

The A V fistula used for dialysis is a surgical connection between an artery and vein. It takes around twelve weeks to mature, and thus must be placed several months before dialysis is anticipated. The infection and stenosis (narrowing) rate is less. The a v fistula can last for years. Previous cannulization of a vein may lead to phlebitis and permanent damage to the vessel wall. This might make it impossible to sustain an a v fistula. For these reasons patients expected to someday start hemodialysis should receive education regarding vein preservation, and have a fistula placed when the glomerular filtration rate is less than 25 cc per minute.

• The AV Fistula
• Preserving Veins
• Fistula Care
• Help save my veins - to be printed for nurse or phlebotomist

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