Abstract: Objective  To evaluate the safety and efficacy of a tunnel cuffed central venous catheter (TCC) re-implantation technique.  Methods  We recruited the hemodialysis patients who had subcutaneous TCC and needed to be replaced in the period from January 2023 to December 2024. General information of the patients, hemodialysis status, previous catheter use and other information were collected. Patients were tried to use the original subcutaneous tunnel to re-implant the catheter in situ. If this manipulation failed, TCC was re-implanted after re-puncture. Surgical techniques, operation time, complications, postoperative catheter use and other information were recorded.  Results  A total of 53 patients were included. TCC was successfully placed using the original subcutaneous tunnel in 45 patients, and was successfully placed after re-puncture in 8 patients. TCC was successfully replaced and used in all patients. The success rate of TCC replacement through the original tunnel was 84.91 %, and the operation time was less than that of re-puncture (t=5.142, P=0.002). There were no complications such as massive hemorrhage and infection after operation. The blood flow in dialysis catheter after operation was 233.77±17.23 ml/min.  Conclusions  Under the guidance of X-ray, the in situ re-placement of TCC with polyester sleeve is safe and effective, which shortens the operation time and reduces the difficulties of operation, and provides a new approach to re-establish the long-term dialysis vascular access.

Key words: Hemodialysis, Vascular access, Tunnel cuffed central venous catheter