Comparison of Heparin-Coated and Conventional Split-Tip Hemodialysis Catheters

Journal Article · Wed Jul 15 04:00:00 EDT 2009 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-009-9608-5· OSTI ID:21428489

Clark, Timothy W. I.,; Jacobs, David; Charles, Hearns W; Kovacs, Sandor; Aquino, Theresa; Erinjeri, Joseph ^[1]; Benstein, Judith A ^[2]

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1. New York University School of Medicine, Section of Vascular and Interventional Radiology, Department of Radiology (United States)
2. New York University School of Medicine, Division of Nephrology, Department of Medicine (United States)

Catheter coatings have the potential to decrease infection and thrombosis in patients with chronic dialysis catheters. We report our midterm experience with a heparin-coated dialysis catheter. This retrospective, case-control study was approved by our Institutional Review Board. A total of 88 tunneled dialysis catheters were inserted over a 13-month period via the internal jugular vein. Thirty-eight uncoated split-tip catheters and 50 heparin-coated catheters were inserted. Primary catheter patency was compared between the two groups using the log rank test, with infection and/or thrombosis considered as catheter failures. Dialysis parameters during the first and last dialysis sessions, including pump speed, actual blood flow, and arterial port pressures, were compared using unpaired t-tests. Primary patency of the uncoated catheters was 86.0 {+-} 6.5% at 30 days and 76.1 {+-} 8.9% at 90 days. Primary patency of heparin-coated catheters was 92.0 {+-} 6.2% at 30 days and 81.6 {+-} 8.0% at 90 days (p = 0.87, log rank test). Infection requiring catheter removal occurred in four patients with uncoated catheters and two patients with heparin-coated catheters (p = 0.23). Catheter thrombosis requiring catheter replacement or thrombolysis occurred in one patient with an uncoated catheter and two patients with heparin-coated catheters (p = 0.9). No differences in catheter function during hemodialysis were seen between the two groups. In conclusion, the heparin-coated catheter did not show a significantly longer patency compared to the uncoated catheter. The flow characteristics of this device were comparable to those of the conventional uncoated catheter. A demonstrable benefit of the heparin-coated catheter in randomized trials is needed before a recommendation for routine implementation can be made.

• OSTI ID: 21428489
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 4 Vol. 32; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
AMINES
ANTICOAGULANTS
CARBOHYDRATES
CARDIOVASCULAR DISEASES
COATINGS
DIALYSIS
DISEASES
DRUGS
HEMATOLOGIC AGENTS
HEPARIN
MUCOPOLYSACCHARIDES
ORGANIC COMPOUNDS
ORGANIC SULFUR COMPOUNDS
POLYSACCHARIDES
SACCHARIDES
SEPARATION PROCESSES
THROMBOSIS
TUBES
VASCULAR DISEASES