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conversion of temporary dialysis catheter to tunneled dialysis catheter


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A small dermatotomy was made in the right infraclavicular region using a #11 blade. The subcutaneous tunnel tract from the right infraclavicular incision to the right lateral neck dermatotomy site was anesthetized with 1% lidocaine with epinephrine. A 23 cm cuff-to-tip Duraflow dialysis catheter was selected. This was tunneled through from the right infraclavicular incision to the right lateral neck dermatotomy site.

Under fluoroscopic guidance, the indwelling temporary dialysis catheter was removed over a 0.035 guidewire and exchanged for a peel-away sheath. The tunneled dialysis catheter was then advanced through the peel-away sheath and positioned with its tip in the mid right atrium. Each lumen was aspirated, flushed, and primed with the appropriate volumes of heparin, 5000 unites perml. The catheter was secured in place with 3-0 Ethilon sutures. The right lateral neck dermatotomy was closed using Indermil adhesive and Steristrips. A fluoroscopic image was obtained confirming satisfactory position of the catheter tip in the mid right atrium.

Successful conversion of right internal jugular temporary dialysis catheter to a tunneled dialysis catheter, 23 cm, tip to cuff.

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