Modified over-the-wire technique for infected tunneled cuffed dialysis catheters exchange: a precious salvage procedure

Background: One of the major troubles related to tunnelled cuffed catheters for hemodialysis is infection. The outcomes of conservative treatment, as an attempt to access salvage, are often poor.Methods: In the present retrospective study, authors reviewed all the patients who underwent infected tunneled cuffed dialysis catheter exchange through a modified over the wire technique. Briefly, this technique consisted in creating a new subcutaneous tunnel away from the old one, preserving the insertion site of the catheter to the vein.Results: Authors have performed infected catheter exchange with this technique in 59 patients. The success rate was 93.2%. Median follow-up was 9 months. There were only 4 patients with signs and symptoms of recurrent catheter infection treated with catheter removal.Conclusions: The modified technique may provide multiple benefits for patients with ESRD. Low recurrence rates, anatomic site preservation and cost effectiveness are some of the advantages of this technique.