Complications following implantation of tunneled central venous catheters

Tunneled central venous catheters (TCVC) are crucial for hemodialysis but implantation involves certain risks. Although considered a simple procedure, severe complications can occur. To avoid acute complications, such as vascular injuries, pneumothorax and malpositioning, correct implantation of the catheter is essential. The right internal jugular vein is the preferred access route. In contrast, the subclavian vein should be avoided in order to reduce the risk of central venous obstructions. The ideal placement of the catheter and its tip is important to prevent thrombosis. The risk of long-term complications (such as catheter-associated infections, dysfunctions due to thrombosis or fibrin sheaths) increases with the duration of an indwelling catheter. Careful planning and execution of catheter implantation are critical to minimize complications. Preventive measures, regular monitoring and identification of high-risk patients as well as patient education are essential strategies for prevention and early detection of problems. The planning of an alternative dialysis access (such as a native shunt or prosthesis shunt) for patients with a prolonged need for dialysis should not be neglected. The article addresses the complications during the implantation and those occurring after implantation and provides strategies for risk reduction.