Improved Tunneling Catheter
Annually, approximately 100,000 US patients suffer end stage renal disease and commence renal dialysis (1). All of these patients require an AV access. Over 70% of patients initiating chronic haemodialysis in the US have a tunnelled central venous catheter (CVC) as their first blood access device and even after 90 days, catheter is still the leading access type (2). Drawing blood from a central vein is technically challenging:
• Removal of blood creates negative pressure around the access point due to direct suction and the Bernoulli effect, this may cause the vein wall to collapse
• A fibrous tissue sheath may form around the catheter, blocking the tip
• If clots form around the tip, the effective catheter diameter decreases and blood flow velocity is increased. This results in an increase in negative pressure and risks pulling the vein wall over the tip (3).
Despite this, catheter design has not developed significantly beyond careful consideration of placement and multi tip catheters. Multi tip catheters reduce the risk of blockage by providing multiple entry points but all are vulnerable to the vein wall covering the tip(s) and to inaccurate placement.
Researchers have patented a novel tunnelling catheter design that eliminates the current design flaws. In particular it:
• Self-locates, ensuring that the tip is always kept away from the vein wall
• Does not rely on multiple tips which make placement difficult
• Reduces the risk of eddy currents
• Modifies blood flow to reduce the risk of clotting
• Is simple and potentially extremely low cost to manufacture
Patent Status Extensive modelling work has validated the design. It is available for licence on a global basis.
(1) US Renal Database, 2009
(2) Centers for Medicare Services (CMS)
(3) Ash, SR. Advances in Tunneled Central Venous Catheters for Dialysis: Design and Performance. Seminars in Dialysis—Vol 21, No 6 (November–December). 2008 pp. 504–515
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