Safety and efficacy of placing internal jugular dialysis catheter tip in the inferior vena cava

Abstract

To assess the efficacy and safety of placing the tip of the internal jugular (IJ) hemodialysis catheter in the inferior vena cava (IVC) in situations where it does not work well when placed in the right atrium. The medical records of chronic hemodialysis patients at an outpatient vascular intervention facility were retrospectively reviewed. Out of the 831 patients who had dialysis catheters exchanged over a 4-year period, 13 patients were identified who underwent catheter exchanges where the tip of the catheter was placed in the IVC via the IJ approach. These were all patients where the catheters had poor flows when placed in the right atrium earlier. Adequate flow (>350 mL/min) was achieved in all 13 cases with the catheter placed in the IVC with no significant complications. This study suggests that exchanging the catheter and placing the tip in the IVC is effective and safe in certain situations especially when the tip placement in the conventional position (i.e. the right atrium) does not work well.