OUTCOME OF TUNNELED HEMODIALYSIS CATHETERS PLACED VIA THE RIGHT INTERNAL JUGULAR-VEIN BY INTERVENTIONAL RADIOLOGISTS

PURPOSE: To assess the outcome of interventional radiologic placement of tunneled hemodialysis catheters via the right internal jugular vein . MATERIALS AND METHODS: In 194 patients, the catheter was placed via the right internal jugular vein unless thrombosis was present. Realtim e ultrasound-guided puncture and fluoroscopic guidance were used. Pati ents were followed up until catheter removal or death. Outcomes evalua ted included infection, thrombosis, and catheter malfunction. RESULTS: In 175 patients, 250 consecutive catheters were placed via the right internal jugular vein with 100% success. All catheters functioned imme diately after placement. Procedural complications were limited to clin ically unimportant air embolus (n = 2). No instances of pneumothorax, hemothorax, or substantial bleeding complications occurred. Follow-up was available in 173 (99%) patients. Mean and median ''catheter durati on'' were 87 and 56 days, respectively. Catheter-related symptomatic v enous thrombosis or stenosis was not observed. The rate of infection w as 0.08 per 100 catheter days, and the rate of malfunction that necess itated removal was 0.22 per 100 catheter days. Definite or possible ca theter thrombosis that necessitated removal occurred at a rate of 0.16 per 100 catheter days. CONCLUSION: Interventional radiologic placemen t of tunneled hemodialysis catheters via the right internal jugular ve in showed equal or better long-term results than those reported for su rgical placement. Interventional radiologic placement should be the me thod of choice.