Episode # 676 • 18 Sept 2026
Use of Tunneled Catheters for Ascites & Effusions Management
When is it time to move from repeat drainage to a tunneled catheter for managing pleural effusions or ascites? On this episode of BackTable Podcast, Dr. Neil Jain interviews Dr. Marco Ertreo, interventional radiologist and IR residency program director at Strong Memorial Hospital, University of Rochester, about best practices for tunneled catheter management in both the chest and abdomen. They discuss the triggers for placing a tunneled catheter, patient selection, placement technique, home drainage protocols, complication management, and the unique considerations for malignant versus cirrhotic ascites.
Timestamps
00:00 - Introduction
06:39 - Indications and Pleural Catheter Placement Technique
12:10 - Tunneling, Cuff Position and Exit Site Selection
17:42 - Home Drainage, Volume Limits and Complications
26:13 - Peritoneal Catheters, TIPS Candidacy and Catheter Choice
35:16 - Avoiding Bowel and Varices
43:42 - Key Takeaways and Closing Remarks
Resources
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More about this episode
Dr. Ertreo shares practical details about pocket selection, access points, catheter testing, and choosing Tenckhoff catheters for abdominal cases to avoid proprietary systems. The conversation covers volume limits, complication counseling, criteria for removal, and the psychological impact of living with a long-term drain. They discuss when to consider TIPS for cirrhotic patients, the importance of early conversations with patients and referring providers, and why multidisciplinary teamwork and family support are essential for long-term success.
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