Surgical aspects of tunneled central venous catheter implantation for hemodialysis: a literature review

This review addresses a key issue in establishing vascular access for maintenance hemodialysis: the implantation of tunneled central venous catheters (TCVCs). Advances in catheter design and imaging technologies in recent years have significantly reduced the risk of complications associated with TCVC placement. Nevertheless, certain complex clinical scenarios still require individualized approaches during implantation. This review highlights the indications and contraindications for TCVC placement, examines the various catheter types and potential insertion sites, and discusses patient preparation, intraoperative considerations, and postoperative care. It also reviews early and late complications, along with strategies for their management. The use of additional imaging modalities to facilitate catheter placement is also presented. Currently, a standardized approach to TCVC implantation is employed, encapsulated in a standard operating procedure (SOP), which ensures adherence to aseptic techniques and provides a structured framework for training new clinical staff.