Comparison of the Symmetrik-Tip vs Split-Tip Tunneled Hemodialysis Catheter: A Retrospective Randomized Trial

ABSTRACT Background: Despite not being the primary choice for vascular access in hemodialysis patients, permanent tunneled catheters are commonly utilized but exhibit elevated rates of complications and dysfunction. This study retrospectively compares the dysfunction durations of symmetric and asymmetric-tipped permanent hemodialysis catheters. Materials and Methods: A total of 307 patients who underwent the placement of either symmetric or asymmetric-tipped permanent tunneled catheters at our interventional radiology clinic between 2021 and 2023 were included. The study aimed to examine the dysfunction rates associated with each type of catheter. Results: Among the included patients, 157 were male (51.1%), and 150 were female (48.9%), with an average age of 65.2±12.2 years. The catheters were predominantly placed in the right jugular in 242 patients (78.8%), followed by the left jugular in 59 patients (19.2%), and femoral placement in 6 patients (2%). Symmetric-tipped catheters were employed in 161 patients (52.4%), while asymmetric-tipped catheters were utilized in 146 patients (47.6%). During follow-up, the catheter dysfunction rate was significantly higher in split-tip catheters than in symmetrical-tip catheters (P< 0.0001). Conclusion: The study revealed a statistically significant increase in catheter dysfunction for the asymmetric-tipped catheter type.