272 tunneled hemodialysis catheters in 229 patients with dwell times of greater than 1 year were identified. Of these, 240 were Ash Split and 32 were Arrow-Clark VectorFlow. For these catheters, the shortest dwell time was 366 days, and the longest was 3,802 days (median 504 days, mean 598 days). The data cover a total of 162,439 catheter days. Overall, the rate of complications requiring removal or exchange was 1.67 per 1,000 catheter days.

Most catheters were removed or exchanged because they were no longer needed, were infected, or had poor flow. 92 catheters (33.8%) were no longer needed because of maturation of arteriovenous access, 88 (32.4%) were removed due to infection, and 64 (23.5%) had poor flow. A complete list of complications can be found in Table 2.

Catheters were placed in the following access veins: right internal jugular (RIJ), right external jugular (REJ), left internal jugular (LIJ), left external jugular (LEJ), collateral veins, right femoral, and left femoral. Most catheters were placed in the RIJ (197, 72.4%) and LIJ (56, 20.6%). A complete list of catheter placements by access vein can be found in Table 3.

Of the 272 catheters, 157 were placed de novo (57.7%) and 113 (41.5%) were exchanged over guidewires. 2 (0.7%) catheters were placed after tract recanalization.

A total of 17 (6.3%) catheters had external component breakage after more than 1 year of dwell time. 10 of these catheters were removed, and 7 were repaired. All the repaired catheters were Ash Split Cath. Dwell times until repair or removal ranged from 377 to 1,436 days (median 489 days, mean 613 days). 5 had a broken hub, 11 had a broken clamp, and 1 had both a broken hub and broken clamp. 12 were Ash Split Cath and 5 were Arrow-Clark VectorFlow. The rate of broken components was 5.0% for Ash Split Cath and 15.6% for Arrow-Clark VectorFlow. With regards to placement location, 10 were placed in the RIJ, 5 in the LIJ, and 2 in collateral veins. 8 were placed de novo, and 9 were placed via exchange over guidewire. Of the catheters placed via exchange, 7 were Ash Split Cath and 2 were Arrow-Clark VectorFlow.

6,515 catheters in 3,693 patients with dwell times of less than 1 year were identified, covering a total of 425,018 catheter days. Ash Split Cath accounted for 5,636 of the catheters, and Arrow-Clark VectorFlow accounted for 812 of the catheters. A total of 48 broken catheters were identified, 38 being Ash Split Cath and 10 being Arrow-Clark VectorFlow. 24 had a broken hub, 17 had a broken clamp, and 7 had a hole. The rate of broken external components < 1 year was 0.7% for Ash Split and 1.2% for Arrow-Clark VectorFlow. Median time to breakage was 110 days, and average time to breakage was 125 days.