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Hemodialysis catheters designed for direct insertion into a central vein, using surgical procedures. These catheters usually consist of a silicone rubber (silastic) tube with several lateral holes; they are inserted and advanced to locate the distal tip in a central vein, typically the superior vena cava or the right atrium (through the subclavian or internal jugular vein punctures), or less frequently in the inferior vena cava (through femoral insertion). Central venous catheters are used temporarily in the case of temporary but reversible access difficulties, acute renal failure, plasmapheresis, ultrafiltration, or dialysis treatment for acute poisoning. They are also permanently implanted for regular hemodialysis treatment in patients, when the peripheral vasculature may be or become unsuitable, or when the arteriovenous fistula is not indicated (e.g., preexisting cardiovascular diseases).
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