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Tunneled Dialysis Catheter Placement

Authors:
  • Cynthia M. Johnson, MA
Publication Type:

Procedure

Tunneled Dialysis Catheter Placement

Definition

Tunneled dialysis catheter placement inserts a tube called a catheter under the skin and into a major vein. The tube has two channels. One sends blood to a dialysis machine where it is filtered and cleaned. The other returns the blood to the bloodstream.

Reasons for Procedure

This procedure is done to allow quick access to blood flow to do dialysis. Dialysis is a process that filters and cleans the blood when the kidneys can no longer do this on their own.

People who have this catheter do not need to have multiple needlesticks at every dialysis visit. This lowers the risk of infection and damage.

Dialysis.

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Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia or contrast material
  • Infection
  • Blood clots
  • Scarring and narrowing of the vein—venous stenosis
  • A collapsed lung
  • Injury to blood vessels or the heart

Things that may raise the risk of problems are:

What to Expect

Problems to Look Out For

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever or chills
  • Increased redness, pain, swelling, or discharge at the insertion sites
  • Pain that you cannot control with medicine
  • Swelling or pain in either arm
  • A catheter that gets wet
  • Accidently kinked a catheter for more than a minute
  • A catheter that moves or falls out
  • Changes in heart rhythm
  • New or worsening symptoms

If you think you have an emergency, call for medical help right away.

Prior to Procedure

The care team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
  • Fasting before the procedure, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from the procedure

Prior to Procedure

The care team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
  • Fasting before the procedure, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from the procedure

Anesthesia

The doctor may give:

  • A sedative—you will feel relaxed
  • Local anesthesia—the area will be numbed

Description of the Procedure

An ultrasound and x-rays using contrast material will be used to help locate the vein and guide catheter placement.

A small cut will be made in the lower neck. A needle will be inserted into the jugular vein. A small guide wire will be passed through the needle and to a larger blood vessel called the vena cava.

A second cut will be made in the chest. A flexible tube will be inserted through the cut, over the guide wire, and to the first cut in the neck. The guide wire will be removed. The other end of the catheter will remain outside of the body, extending through the second cut. The doctor will make sure that blood is flowing in the catheter.

The placement of the catheter will be checked using x-rays. The catheter will be secured with stitches. Some catheters have a cuff that sits in the tunnel under the skin. This cuff helps keep the tube secure and free of infection. The first cut will be closed with stitches, staples, or glue. The second cut will be stitched around the catheter to help it stay in place. Both areas will be bandaged.

How Long Will It Take?

Less than 1 hour

Will It Hurt?

Anesthesia will prevent pain during the procedure. Pain is common in the first few days. Medicine and home care can help.

Post-procedure Care

At the Care Center

After the procedure, the staff may:

  • Give you pain medicine
  • Teach you how to care for the area

During your stay, staff will take steps to lower your chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your wounds covered

You can also lower your chance of infection by:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your wounds

At Home

Recovery can take 2 to 4 weeks. You may need to ask for help with daily activities. Some physical activities may need to be limited during this time.

RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • Hemodialysis. National Institute of Diabetes and Digestive and Kidney Disorders website. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/hemodialysis.
  • Hemodialysis catheters: How to keep yours working well. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/hemocatheter.
  • Hemodialysis for end-stage renal disease. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/hemodialysis-for-end-stage-renal-disease.
  • Vascular access procedures. Radiological Society of North America Radiology Info website. Available at: https://www.radiologyinfo.org/en/info/vasc_access.

Contributors

  • Mark S. Itzkowitz, MD, JD
Last Updated:
2022-09-01

(C) Copyright 2023 EBSCO Information Services

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.