Abstract: Objective  This study aims to evaluate the effectiveness of double guide wire technique through the binding of fibrin sheath to improve long-term patency rate of tunneled-cuffed catheter (TCC).  Methods  A retrospective study was conducted on the patients undergoing TCC replacement due to fibrin sheath at Beijing Zhongguancun Hospital from January first to September 30, 2024. Double guide wire technique through the binding of fibrin sheath was used to re-implant TCC. Clinical data, surgical information, and follow-up study within 180 days were collected to evaluate TCC patency.  Results  A total of 30 patients were included in this study. The success rate of TCC replacement using double guide wire to break the fibrin sheath constraint was 100%. No surgery-related complications such as massive hemorrhage, pericardial tamponade and catheter-related infections happened in perioperative period. After catheter replacement for 90 and 180 days, the primary patency rates were 93.3% and 80.0% respectively, and the primary assistant patency rates were 100% and 90.0% respectively.  Conclusion  The double guide wire technique through the binding of fibrin sheath is a safe and effective method for in situ replacement of TCC.

Key words: Maintenance hemodialysis, Central venous catheters, In situ catheterization; , Catheter related fibrin sheath