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Kastamonu Medical Journal

Kastamonu Medical Journal regularly publishes internationally qualified issues in the field of Medicine in the light of up-to-date information.

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Original Article
Outcomes of success rates and complications in ultrasound-guided tunneled hemodialysis catheter placement via the right internal jugular vein
Abstract
Aims: The selection of optimal vascular access is crucial for chronic hemodialysis (HD) patients, with arteriovenous fistulas (AVFs) recommended as the first-line option. However, in cases where AVFs are not viable, tunneled hemodialysis catheters (THCs) provide a reliable alternative. This study aimed to evaluate the technical success rates and both short- and long-term complications associated with THCs placed via the right internal jugular vein (IJV) under ultrasound (US) guidance.
Methods: In this retrospective study, 160 patients with end-stage renal disease (ESRD) underwent THC placement via the right IJV using US and fluoroscopic guidance between September 2022 and September 2024. Demographic data, catheter placement details, and post-procedural outcomes were obtained from the hospital records and analyzed. Catheter dysfunction, defined by failure to maintain adequate blood flow or dialysis efficiency, was monitored, as were complications such as infection, thrombosis, and fibrin sheath formation.
Results: A total of 226 catheters were placed in 160 patients with a technical success rate of 99%. The first-attempt success rate under US guidance was 89%, with minor complications observed in only 7% of procedures. Long-term follow-up (average of 196 days) indicated that venous thrombosis occurred in 2 patients, venous stenosis in 4 patients, and fibrin sheath formation in 3 patients. Catheter dysfunction led to replacement in 29 patients, with further interventions required in 12 cases. No major complications, such as pneumothorax or significant bleeding, were observed.
Conclusion: THCs placed via the right IJV under US guidance achieved high technical success rates and low complication rates, supporting their efficacy and safety for long-term use in HD patients. The findings align with current literature on the benefits of US guidance in reducing complications and improving procedural success. Given the study's retrospective and single-center limitations, additional research with larger, multicenter cohorts is recommended to validate these results and optimize catheter placement practices for high-risk patients.

Keywords : Tunneled hemodialysis catheter, right internal jugular vein, ultrasound, interventional radiology

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1. Murea M, Geary RL, Davis RP, Moossavi S. Vascular access for hemodialysis: a perpetual challenge. Semin Dialys. 2019;32(6):527-534. doi:10.1111/sdi.12828
2. Kamar F, Quinn RR, Oliver MJ, et al. Outcomes of the first and second hemodialysis fistula: a cohort study. Am J Kidney Dis. 2019;73(1):62-71. doi:10.1053/j.ajkd.2018.06.007
3. Lok CE, Huber TS, Lee T, et al. KDOQI clinical practice guideline for vascular access: 2019 update. Am J Kidney Dis. 2020;75(4 Suppl 2):S1-S164. doi:10.1053/j.ajkd.2019.12.001
4. Ecevit A, Karaca OG, Kalender M, Darçın OT. Infection rate of tunneled hemodialysis catheters. Duzce Med J. 2021;23(1):55-60. doi:10.18678/dtfd.869083
5. Gupta PC, Burli P. Ultrasound-guided vascular access. J Indian Coll Cardiol. 2016;6:92-94. doi:10.1016/j.jicc.2015.10.019
6. Kunhahamed MO, Abraham SV, Palatty BU, Krishnan SV, Rajeev PC, Gopinathan V. A comparison of internal jugular vein cannulation by ultrasound-guided and anatomical landmark technique in resource-limited emergency department setting. J Med Ultras. 2019;27(4):187-191. doi:10.4103/jmu.Jmu_2_19
7. Yaqub S, Abdul Razzaque MR, Aftab A, Siddiqui NA. Outcomes of tunneled cuffed hemodialysis catheters: an experience from a tertiary care center in Karachi, Pakistan. J Vasc Acc. 2022;23(2):275-279. doi:10. 1177/1129729821989904
8. Raheem A, Rana AI, Mehmood SN, Ramzan M, Shah RA, Naseem S. Two years experience with tunneled dialysis catheters in patients requiring haemodialysis. J Pakistan Med Assoc. 2014;64(7):758-761.
9. Lefrant JY, Muller L, De La Coussaye JE, et al. Risk factors of failure and immediate complication of subclavian vein catheterization in critically ill patients. Intens Care Med. 2002;28(8):1036-1041. doi:10.1007/s00134-002-1364-9
10. Trerotola SO, Johnson MS, Harris VJ, et al. Outcome of tunneled hemodialysis catheters placed via the right internal jugular vein by interventional radiologists. Radiology. 1997;203(2):489-495. doi:10.1148/radiology.203.2.9114110
11. Hamid RS, Kakaria AK, Khan SA, et al. Safety and complications of double-lumen tunnelled cuffed central venous dialysis catheters: clinical and radiological perspective from a tertiary centre in Oman. Sultan Qaboos Uni Med J. 2015;15(4):e501-e506. doi:10.18295/squmj.2015.15.04. 010
12. Abdo EM, Ibrahim AH, Kasem SA, Sakr LK, Mohamed HI. Outcome of ultrasound-guided insertion of internal jugular vein permanent hemodialysis catheters. Egyptian J Hospit Med. 2023;91(1):4255-4264. doi:10.21608/ejhm.2023.296198
13. Gok M, Gunduz D. Image guided central venous catheter placement. Livre de Lyon; 2001.
14. Denys BG, Uretsky BF, Reddy PS. Ultrasound-assisted cannulation of the internal jugular vein. A prospective comparison to the external landmark-guided technique. Circulation. 1993;87(5):1557-1562. doi:10. 1161/01.CIR.87.5.1557
15. Oguzkurt L, Tercan F, Kara G, Torun D, Kizilkilic O, Yildirim T. US-guided placement of temporary internal jugular vein catheters: immediate technical success and complications in normal and high-risk patients. Eur J Radiol. 2005;55(1):125-129. doi:10.1016/j.ejrad.2004. 10.004
16. Lund GB, Trerotola SO, Scheel PF, et al. Outcome of tunneled hemodialysis catheters placed by radiologists. Radiology. 1996;198(2): 467-472. doi:10.1148/radiology.198.2.8596851
17. Marik PE, Flemmer M, Harrison W. The risk of catheter-related bloodstream infection with femoral venous catheters as compared to subclavian and internal jugular venous catheters: a systematic review of the literature and meta-analysis. Critic Care Med. 2012;40(8):2479-2485. doi:10.1097/CCM.0b013e318255d9bc
18. Lorente L, Jiménez A, García C, et al. Catheter-related bacteremia from femoral and central internal jugular venous access. Eur J Clin Microbiol Infect Dis. 2008;27(9):867-871. doi:10.1007/s10096-008-0507-5
19. Sazdov D, Srceva MJ, Todorova ZN. Comparative analysis of ultrasound guided central venous catheterization compared to blind catheterization. Prilozi. 2017;38(2):107-114. doi:10.1515/prilozi-2017-0028
20. Koroglu M, Demir M, Koroglu BK, et al. Percutaneous placement of central venous catheters: comparing the anatomical landmark method with the radiologically guided technique for central venous catheterization through the internal jugular vein in emergent hemodialysis patients. Acta Radiol (Stockholm, Sweden : 1987). 2006; 47(1):43-47. doi:10.1080/02841850500406845
21. Farrell J, Gellens M. Ultrasound-guided cannulation versus the landmark-guided technique for acute haemodialysis access. Eur Renal Assoc. 1997;12(6):1234-1237. doi:10.1093/ndt/12.6.1234
22. Tamtekin B, Güler Gülsen E. Permanent hemodialysis catheters inserted with traditional (blind) technique: 10 years experience. Kastamonu Med J. 2024;4(3):80-83. doi:10.51271/KMJ-0148
23. Doerfler ME, Kaufman B, Goldenberg AS. Central venous catheter placement in patients with disorders of hemostasis. Chest. 1996;110(1): 185-188. doi:10.1378/chest.110.1.185
24. -Mumtaz H, Williams V, Hauer-Jensen M, et al. Central venous catheter placement in patients with disorders of hemostasis. Am J Surg. 2000; 180(6):503-505. doi:10.1016/s0002-9610(00)00552-3
25. Caner Ö ZER, Altan Y. Kalıcı tünelli hemodiyaliz kateterlerinin etkinliği ve uzun dönem sonuçları. Cukurova Med J. 2018;43(4):989-993.
26. Mohazzab A, Khavanin Zadeh M, Dehesh P, Abdolvand N, Rahimi Z, Rahmani S. Investigation of risk factors for tunneled hemodialysis catheters dysfunction: competing risk analysis of a tertiary center data. BMC nephrology. 2 2022;23(1):300. doi:10.1186/s12882-022-02927-z
27. Engstrom BI, Horvath JJ, Stewart JK, et al. Tunneled internal jugular hemodialysis catheters: impact of laterality and tip position on catheter dysfunction and infection rates. J Vasc Intervent Radiol. 2013;24(9):1295-302. doi:10.1016/j.jvir.2013.05.035
Article available in :
Volume 5, Issue 1, 2025
Page : 55-59
https://doi.org/10.51271/KMJ-0184
Article Information
Received : 22 Kas 2024
Accepted : 22 Oca 2025
Published : 04 Mar 2025
Corresponding Author :

İsmail Taşkent: Department of Radiology, Faculty of Medicine, Kastamonu Univesity, Kastamonu, Turkiye

[email protected]
Citation : Taşkent İ. Outcomes of success rates and complications in ultrasound-guided tunneled hemodialysis catheter placement via the right internal jugular vein. Kastamonu Med J. 2025;5(1):55-59.

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