Is a vascular access (vas) catheter a dialysis catheter?

Vascular Access (Vas) Catheter is a Dialysis Catheter

Yes, a vascular access (vas) catheter is a type of dialysis catheter used for hemodialysis access. 1

Types of Dialysis Catheters

Dialysis catheters can be categorized into several types based on their design and intended duration of use:

1. Short-term noncuffed catheters (NCCs)

   • Used for acute dialysis (typically 3-5 sessions within 1 week)
   • Not tunneled under the skin
   • Higher infection risk

2. Long-term tunneled cuffed catheters (TCCs)

   • Used when dialysis is needed for more than 1 week
   • Tunneled under the skin with a cuff that helps anchor the catheter
   • Reduced infection risk compared to NCCs
   • Also referred to as "vascular access catheters" or "vas caths" 1

3. Port catheter systems

   • Subcutaneously placed devices connected to catheter tubing
   • Accessed percutaneously using buttonhole technique
   • Special cannulation needles required 1

Characteristics of Tunneled Dialysis (Vas) Catheters

Tunneled dialysis catheters (vas caths) have several key features:

• Dual lumen design (typically "double D" configuration)
• Tips positioned within the right atrium for optimal flow
• Capable of delivering blood flow rates of 300-400 mL/min
• Tunneled under the skin with a cuff to reduce infection risk
• Designed for immediate use without maturation time 1

Placement Considerations

The preferred insertion site for tunneled dialysis catheters is:

1. Right internal jugular vein (first choice)

   • More direct route to right atrium
   • Lower risk of complications
   • Better blood flow rates 1

2. Left internal jugular vein (second choice)

   • Potentially poorer blood flow rates
   • Higher risk of stenosis and thrombosis
   • May jeopardize future vascular access on ipsilateral side 1

3. Femoral vein (third choice)

   • Higher infection rates
   • Should be reserved for bed-bound patients 1

4. Subclavian vein (avoid if possible)

   • High risk of central venous stenosis
   • Can permanently exclude future AV access creation 1

Clinical Implications

While vascular access (vas) catheters are essential for immediate dialysis access, they have important limitations:

• Higher morbidity from thrombosis and infection compared to AV fistulas/grafts
• Risk of central venous stenosis or occlusion
• Shorter expected use-life than other access types
• Lower blood flow rates, potentially requiring longer dialysis times 1

Best Practices

According to guidelines, tunneled dialysis catheters should be:

• Used for as brief a period as necessary
• Limited to <10% of chronic maintenance hemodialysis patients
• Considered a bridge to more permanent access (AV fistula or graft)
• Placed with fluoroscopic guidance to ensure proper tip positioning
• Monitored for complications including infection and thrombosis 1

Conclusion

In summary, a vascular access (vas) catheter is indeed a dialysis catheter, specifically referring to a tunneled catheter used for hemodialysis access. While essential for immediate dialysis needs, guidelines recommend transitioning to more permanent access options (preferably AV fistulas) when possible to reduce complications and improve patient outcomes.