Management of some uncommon but significant complications of the tunneled cuffed catheter for hemodialysis

Although use of the autogenous arteriovenous fistula is the first choice for vascular access for hemodialysis, the tunneled cuffed catheter (TCC) remains an important alternative method that is applied widely in maintenance hemodialysis for patients with end-stage renal disease. In addition to common complications, such as thrombosis, infection, formation of a fibrin sheath, or central vein stenosis, TCC dysfunction, such as kinks, cuff detachment, or mechanical destruction, can be easily overlooked. The reasons for these clinical problems are multifactorial and include the insertion handling, presence of diabetes mellitus, catheter type, malnutrition, and the patient's body habitus. This minireview describes our experience with TCC and the current literature on managing TCC dysfunction.