Totally subcutaneous hemodialysis access: experience with the LifeSite Hemodialysis System.

The LifeSite Hemodialysis System (Vasca, Inc., Tewksbury, MA) is totally subcutaneous, incorporating two silicone catheters positioned in the central venous system and connected to a stainless steel-titanium valve implanted in a subcutaneous pocket. A randomized trial and nonrandomized clinical experience have demonstrated lower rates of infection and longer device survival when 70% isopropyl alcohol is used as the antimicrobial solution with the LifeSite. Internal jugular vein placement with positioning of the valve on the anterior chest wall further improves results.