Comparison of Blood Flow Rates and Hydraulic Resistance Between the Mahurkar Catheter, the Tesio Twin Catheter, and the Ash Split Cath

The Ash Split Cath (Medcomp, Harleysville, PA) is a recently introduced dual lumen permanent catheter designed to be placed through the internal jugular vein into the superior vena cava by single venipuncture technique. The transcutaneous portion is a 14 French cylindrically shaped catheter with Dshaped lumens and a Dacron (DuPont, Wilmington, DE) cuff. At the entrance to the jugular vein, the catheter splits into two separate D-shaped limbs that then merge into multiholed cylindrical tips in the vena cava. Split Caths (n = 10) have been placed in patients with end-stage renal disease and used for outpatient dialysis for approximately 2 months. Flow rates and hydraulic resistance have been compared with Mahurkar (Bard, Salt Lake City, UT) (n = 22) and Tesio (Medcomp) (n = 17) catheters in the same unit. Average blood flow rates (Qb) were 295 ± 42 (SD) for Ash Split Caths vs 279 ± 38 and 300 ± 39 ml/min for Mahurkar and Tesio catheters, respectively, and hydraulic resistances were 0.44 ± 0.17,0.52 ± 0.15, and 0.56 ± 0.11 mmHg/ml/min, respectively (not significant). No Split Caths have been removed for bleeding or flow complications. The Split Cath provides catheter with flow advantages of independent, cylindrical, multiholed tips.