Abstract
The number of hemodialysis patients who are elderly or receiving long term maintenance treatment has increased in recent years. At the same time, episodes of difficulty with blood access have increased. We describe the long-term use of the SOFT-CELL® (Vas-Cath, Ontario, Canada) double-lumen catheter for hemodialysis in 4 patients with a history of multiple problems related to maintenance of blood access. SOFT-CELL® was inserted into the right subclavian vein under local anesthesia. A subcutaneous tunnel was made about 6cm downwards to an exit site on the anterior chest wall. In one of the 4 patients, the catheter was removed 3 days after insertion because of non-sustained ventricular tachycardia (NSVT). The catheter, which was too long, irritated the tricuspid valve in the right atrium and induced NSVT. With the exception of this case who developed an arrhythmia, catheter-related complications have not been recognized to date. Arrhythmia can be avoided if an adequate length is chosen. Thus, the SOFT-CELL® double-lumen catheter was considered to potentially provide good long-term blood access if major catheter-related complications such as infection and thrombus can be prevented.
