ULTRASONIC GUIDANCE FOR PERCUTANEOUS PUNC TURE OF THE INTERNAL JUGULAR-VEIN PER TWIN HEMODIALYSIS CATHETERS

Despite significant progress, vascular access remains a major concern for nephrologists. For the last 6 years we have used as temporary vasc ular access silastic twin catheters implanted into the internal jugula r vein based on Canaud's method. We have developed in 15 patients an u ltrasound-guided method using an ultrasonic Doppler to improve access to the internal jugular vein, prior to its catheterization. Ultrasound assistance was provided by a 5MHz mechanical sectorscanning transduce r (Toshiba 270A). The internal jugular vein and carotid artery were vi sualized. The skin overlying the internal jugular vein was marked with indelebile ink. The internal jugular vein was cannulated successfully in 14 patients. The use of ultrasound guidance to cannulate the inter nal jugular vein improves success, and reduces complications. This met hod is recommended in patients with distorted cervical or subclavicula r anatomic characteristics, or with bleeding tendency.