What is a vascath (vascular catheter)?

From the Guidelines

A vascath, or vascular catheter, is a medical device used to provide temporary vascular access for patients requiring hemodialysis, plasmapheresis, or rapid fluid administration. It is typically a large-bore catheter inserted into a major vein, such as the internal jugular, subclavian, or femoral veins, under sterile conditions using ultrasound guidance 1. The catheter usually consists of a dual-lumen tube with one port for drawing blood and another for returning it, allowing for simultaneous blood removal and return. Vascaths are designed for short-term use, usually days to weeks, while awaiting more permanent access options like arteriovenous fistulas for patients requiring ongoing dialysis 1.

Key Characteristics of Vascaths

• They are typically dual-lumen tubes with one port for drawing blood and another for returning it
• They are inserted into major veins under sterile conditions using ultrasound guidance
• They are designed for short-term use while awaiting more permanent access options
• They require regular maintenance, including flushing with heparin or saline between uses to maintain patency

Important Considerations

• Patients with vascaths should avoid submerging the insertion site in water
• Patients should report any signs of infection, such as redness, swelling, pain, or fever
• Healthcare providers must follow proper protocols for catheter placement, maintenance, and removal to minimize the risk of complications, including infection, thrombosis, bleeding, and catheter malfunction 1.

Clinical Guidelines

• Long-term catheters and port catheter systems should be reserved for patients with severe comorbidities, such as congestive heart failure (CHF) and severe peripheral vascular disease (PVD), the very elderly, those with inadequate vascular anatomy, or those with limited life expectancy 1
• The choice of catheter should be based on local experience, goals for use, and cost, with a preference for catheters capable of rapid blood flow rates 1

From the Research

Definition of Vascath

• A vascath, also known as a vascular catheter, is a type of catheter used for vascular access in patients undergoing hemodialysis 2, 3, 4, 5, 6.
• Vascular catheters can be further classified into different types, including tunneled catheters, arteriovenous fistulas, and arteriovenous grafts 2, 3, 5.

Types of Vascular Catheters

• Tunneled catheters are a type of vascular catheter that is inserted under the skin and remains in place for an extended period 2, 3, 4, 6.
• Arteriovenous fistulas are a type of vascular access that involves surgically connecting an artery and a vein, allowing for dialysis to be performed 2, 5.
• Arteriovenous grafts are a type of vascular access that involves surgically implanting a tube made of synthetic material between an artery and a vein, allowing for dialysis to be performed 2, 3, 5.

Complications Associated with Vascath

• Vascular catheters are associated with several complications, including thrombotic occlusion, infection, and catheter-related bloodstream infections (CRBSIs) 2, 3, 4, 5, 6.
• The risk of CRBSIs is higher in patients with tunneled catheters compared to those with arteriovenous fistulas or grafts 3, 4, 5.
• Locking solutions, such as citrate and taurolidine-based solutions, can be used to prevent thrombotic and infectious complications associated with vascular catheters 6.