NDT Advance Access published online on August 8, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn456
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The great saphenous vein for central venous access and haemodialysis
Transplant Surgery Group, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK
Correspondence and offprint requests to: Phillip J. Yates, Transplant Surgery Group, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK. Tel: +44-116-2584604; Fax: +44-116-2490064; E-mail: pjy4{at}le.ac.uk
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Abstract |
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Background. Utilising an open surgical technique the Great Saphenous vein in the proximal thigh can be used for the insertion of central venous catheters for haemodialysis. This approach is safe and efficacious, and may be performed under local or general anaesthesia. This technique is of particular importance in patients requiring vascular access for haemodialysis in whom the upper central veins are stenosed and the femoral vessels are not amenable to percutaneous cannulation.
Methods. The Great saphenous vein is exposed via a surgical incision in the thigh. The central venous catheter is then inserted and advanced until in the desired position, as confirmed on fluoroscopy.
Results. Seven Great saphenous catheters were placed over a period of six months. All catheters insertions were technical successes with completion of at least one dialysis session. Primary patency rates were 57%, 49%, 23% at 30, 60 and 90 days respectively.
Conclusion. The great saphenous vein offers an additional site for the insertion of central venous catheters. These data demonstrate equivalence in patency between this novel technique and percutaneous femoral vein cannulation.
Keywords: central venous cannulation; great saphenous vein; haemodialysis
Received for publication: 8. 4.08
Accepted in revised form: 16. 7.08