Dialysis catheters in jugular veins

Case contributed by Dr Paresh K Desai
Modality: X-ray

Right IJV double lumen dialysis catheter - tunnelled in the anterior chest wall - with fluid overload status.

Different patient

Modality: X-ray

Left IJV double lumen dialysis catheter - tunnelled. The lungs reveal fluid overload status.

Case Discussion

Jugular vein puncture is done under local anaesthesia using ultrasound guidance. Guidewire is secured in the right atrium or a the cavo-atrial junction under fluoroscopy over which a jugular sheath is placed. The dialysis catheter is inserted through a subcutaneous tunnel on the chest wall and is placed within the sheath - which is peel-away type of sheath. The sheath is peeled off keeping the catheter in position.

Right internal jugular vein is preferred for jugular dialysis catheters due to its straight access into the superior vena cava and the right atrium. These are placed through a tunnel in the subcutaneous plane with a dacron cuff positioned in the centre of the tunnel around the catheter. The usual dialysis catheters are double lumen - one each for inflow and outflow. Triple lumen dialysis catheters may also be used - the third lumen used for intravenous fluid / drugs administration / central venous pressure assessment.

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Case Information

rID: 30937
Case created: 10th Sep 2014
Last edited: 3rd Dec 2015
Inclusion in quiz mode: Excluded

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