Ultrasound-Guided Placement of Tunneled Dialysis Catheters Without Fluoroscopic Assistance: A Retrospective Analysis

Background Tunneled cuffed catheters (TCCs) are crucial for hemodialysis (HD) when permanent access is not feasible. This study evaluates the effectiveness of non-fluoroscopic guided TCC placement. Materials and Methods We reviewed data from adult patients with CKD who had non-fluoroscopic guided TCC insertions over 2 years at our hospital. Results TCCs were used as a bridge to arteriovenous fistula (AVF) creation (62%) or as permanent access in 150 (26%) patients. Most (92%) were placed in the right internal jugular vein (IJV). The average catheter use duration was 7.19 months; 63.3% of cases were followed up till catheter removal. Key reasons for removal included AVF maturation (41.3%), kidney transplantation (11.3%), and catheter-related problems (10.7%). Among 36.7% lost to follow-up, 33.3% were due to non-catheter-related deaths. Higher complication rates were noted in patients with coronary artery disease, multiple access failures, catheters used for >6 months, and femoral insertion sites ( p < 0.001). Immediate complications were low (2.7%), but catheter-related bloodstream infections (CRBSI) occurred in 25.3% cases. Most patients (82.7%) did not require further interventions; however, 17.3% had catheter dysfunction, with occlusion being the most common. Streptokinase achieved a 44% success rate. Conclusion This study shows that ultrasound-guided, non-fluoroscopic methods achieve comparable success rates of catheter survival and complication rates similar to those of fluoroscopic techniques, while eliminating radiation exposure and reducing costs.