Long-term experience with Swan Neck Missouri catheters.

The Swan Neck Missouri catheters are designed to reduce major complications including 1) exit/tunnel infections, by a downward directed exit hole; 2) pericatheter leaks, by placement of the deep cuff in the rectus muscle; 3) catheter tip migration, by caudal direction of the intraperitoneal segment; and 4) outer cuff extrusion, by a permanent bend between the 5 cm or 3 cm spaced cuffs in SN-M2 and SN-M3 catheters, respectively. Between April 1986 and April 1990, 103 swan neck catheters were implanted. Comparison of prospective data from 103 swan neck catheters and retrospective data from 148 standard (Tenckhoff and Toronto Western Hospital) catheters implanted between January 1982 and June 1985 showed reduced complication rates with swan neck catheters. An overall survival of 64% at 36 months for swan neck catheters is significantly better than that of 29% for standard catheters.