The Catheter-Challenged Patient and the Need to Recognize the Recurrently Dysfunctional Tunneled Dialysis Catheter


Address correspondence to: Randall L. Rasmussen, Lifeline Vascular Access, 3 Hawthorn Parkway, Suite 410, Vernon Hills, IL 60061, or e-mail:


Tunneled dialysis catheters (TDC) become dysfunctional because of placement problems, infection, thrombosis, and fibrin sheath formation. Occasional patients who are catheter dependant develop frequent catheter dysfunction because of thrombosis or thrombosis associated with fibrin sheath formation. This article attempts to define which dysfunctional catheters because of thrombosis and thrombosis associated with fibrin sheath formation actually represent a recurrently dysfunctional TDC (RDC) and puts forth an approach to managing the RDC.