Demers or atrial catheters

The Demers or atrial catheter is a tunnelled, central venous catheter that is primarily used for dialysis. High flow rates (volume over time) are needed for dialysis, so Demers / atrial catheters have a higher diameter (approx. 4.5 – 5.5 mm) compared to other central venous catheters.

This catheter is known as a Demers catheter after the first person to describe it and an atrial catheter because its tip is positioned in the right atrium.

In addition to the general advantages of “tunnelling” (see “Tunnelled catheter”), the Demers catheter also allows outpatient dialysis treatment since very high blood flows (volume over time) are needed for this. With a Demers catheter, the time needed for “maturing” of the surgical connection between the brachial artery and vein (dialysis shunt) – needed for long-term haemodialysis – can be bridged.

Nowadays, Demers or atrial catheters usually have two separate channels (lumens) running inside them. This allows the dialysis process to be shortened because the dialysis machine can transport blood for cleaning through one lumen and transport blood that has already been cleaned back into the body through the second lumen at the same time but in the opposite direction.

Figure 1: Demers or atrial catheter. The tip of the catheter is positioned for a high flow of blood in the right atrium.

Figure 2: The illustration shows the moment of ultrasound-guided venepuncture on the right above the collarbone (the patient’s head is show on the left in the picture). The ultrasound monitor (right-hand side of the picture) shows the vein (long thin arrow in the monitor image) and a bright spot can be seen inside it. This spot represents the tip of the needle and indicates that the vessel has been pierced successfully. The correct positioning is also checked by drawing off a little blood before continuing with the catheter placement.

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Video 1: Illustration of ultrasound-guided venepuncture on the right above the collarbone (the patient’s head is show on the left in the video). The interventional radiologist tracks the introduction of the needle on the ultrasound monitor. On this monitor, the vein appears dark while the tip of the needle is shown as a bright spot. Once the bright spot appears inside the vessel, the radiologist can see that the vessel has been punctured successfully. The correct positioning is also checked by drawing off a little blood before continuing with the catheter placement (video kindly provided by Dr de Bucourt).

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Minimally Invasive Tumour Therapy (MITT)
Charité Campus Virchow-Klinikum (CVK)
Department of Radiology
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13353 Berlin

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