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    • Double Wire, a Novel Technique for the Insertion of Tunneled Venous Catheter for Hemodialysis

    Mohamed El-Maadawy, MD.
    Vascular Surgery Unit, Faculty of Medicine, Cairo University

    Objective: to present the experience in and outline the technique for insertion of tunneled catheters using two wires. Patients and Methods: We applied the double wire technique in 26 patients for their tunneled catheter insertion. Twenty patients had debut tunneled catheter insertion. Five patients benefitted the technique for replacing their malfunctioning (four patients) or damaged (one patient) catheter. Additional patient had the catheter rescued after a mishap occurred during its insertion. Techniques for catheter insertion, catheter replacement and adjusting catheter position were presented. Results: All procedure were complimented by patients’ comfort. Blood loss was unaccountable in all cases and no single suspicion of air embolism was reported. It happened once in a patient subjected to insertion of tunneled catheter through left common femoral vein (CFV) to develop asymptomatic ventricular tachycardia. It was picked up by ECG monitoring. The event reverted immediately upon withdrawal of the wire out of the right atrium. We did not encounter any puncture site complictions. Conclusion: The technique is simple and easy to performe and to reproduce. Both patient and operator satisfaction complimented the technique. Key Words: Sheathless, Double wire, Hemodialysis catheter.

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