Tunneled Cuffed Catheter (or Tunneled Cuffed Venous Catheter)
The chest catheter used for hemodialysis is called a tunneled cuffed catheter (TCC) or tunneled cuffed venous catheter. 1, 2, 1
Key Terminology
The proper medical terminology includes:
- Tunneled cuffed catheter (TCC) - the most common term in clinical guidelines
- Tunneled cuffed venous catheter - the full descriptive name
- Long-term catheter - functional descriptor (for use >3 weeks)
- Cuffed dialysis catheter - simplified clinical term
These are distinct from noncuffed catheters (NCCs) or short-term catheters, which are temporary devices used for <1 week and are not tunneled. 1
Design Features
Tunneled cuffed catheters have specific characteristics that distinguish them 1, 2:
- Double-lumen design - allows simultaneous blood withdrawal and return
- Subcutaneous cuff - promotes tissue ingrowth to secure the catheter and reduce infection risk
- Tunneled pathway - travels 8-15 cm through subcutaneous tissue before entering the vein
- Preferred insertion site - right internal jugular vein
- Tip position - at the caval-atrial junction or right atrium (confirmed by fluoroscopy)
Clinical Context
For hemodialysis access >3 weeks duration, tunneled cuffed catheters are the catheter of choice. 1 They provide immediate access without maturation time and are universally applicable, though they carry higher infection and thrombosis risks compared to arteriovenous fistulas or grafts. 2
The term "right atrial catheter" should be avoided as it is imprecise - these are properly called tunneled cuffed catheters regardless of insertion site. 2