J Korean Soc Radiol.  2010 Oct;63(4):351-357.

Placement of a Hemodialysis Catheter using the Dilated Right External Jugular Vein as a Primary Route

• Park MH
• Shin BS

Abstract

PURPOSE
To evaluate the feasibility that a dilated right external jugular vein (EJV) could be a primary venous access site for large bore hemodialysis catheter placement.
MATERIALS AND METHODS
Between January 2008 and April 2009, a total of 173 hemodialysis catheters (14.5 F) were placed. Among them, we evaluated the clinical data of 42 patients who underwent placement through a dilated right EJV. We evaluated technical success, duration of catheterization in days, and the presence of complications.
RESULTS
Technical success was achieved for 41 patients (98%). Catheter placement was unsuccessful in one patient due to narrowing of the EJV. The catheter dwell time ranged between 14 and 305 days (mean; 76 days, total catheter days: 3,111 days). A total of 26 hemodialysis catheters were removed due to complications (n=2) and termination of hemodialysis via the hemodialysis catheter (n=24). There was air embolization (n=1) and catheter kinking (n=3) during procedures and catheter related infections (n=2) during the follow-up period. The incidence of catheter related infection was 0.06 per 100 catheter days. No cases of catheter malfunction or symptomatic venous thrombosis were observed.
CONCLUSION
We suggest that a dilated right EJV could be considered as a preferred primary route for hemodialysis catheter placement with easy access.

MeSH Terms

Catheter-Related Infections
Catheterization
Catheters
Catheters, Indwelling
Follow-Up Studies
Humans
Incidence
Jugular Veins
Renal Dialysis
Venous Thrombosis

Figure

• 

  Fig. 1 Anatomic variations of the external jugular vein. A. The EJV enters into the jugulo-subclavian venous confluence (type A). B. Into the SCV at a distance from its junction with the IJV (type B). C. Into the trunk of the IJV (type C). The dotted line indicates the expected course of the hemodialysis catheter.

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