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. 2018 Jun;46(6):2481-2485.
doi: 10.1177/0300060518766649. Epub 2018 Apr 24.

Failure to place a tunneled hemodialysis catheter due to malformation of right internal jugular vein draining to subclavian vein

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Failure to place a tunneled hemodialysis catheter due to malformation of right internal jugular vein draining to subclavian vein

Li-Na Zhu et al. J Int Med Res. 2018 Jun.

Abstract

The right internal jugular vein (IJV) is an important access site for hemodialysis catheterization. Venous cannulation failure is usually caused by central venous stenosis and is rarely related to vessel malformation. We herein present a case of failure to place a tunneled hemodialysis catheter into the right IJV. The patient had an arteriovenous fistula in the right arm with inadequate flow and a history of multiple central venous catheterizations. The guidewire was repeatedly misplaced into the right subclavian vein (SV) regardless of the technique used. Computed tomography venography revealed that the inferior segment of the right IJV drained into the ipsilateral SV. To the best of our knowledge, this is the first report of catheterization failure due to abnormal drainage of the right IJV into the ipsilateral SV.

Keywords: Renal dialysis; catheterization; central vein; malformation; right internal jugular vein; subclavian vein.

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Figures

Figure 1.
Figure 1.
Right internal jugular vein draining to ipsilateral subclavian vein with an angle of about 35 degrees. ♦ Right subclavian vein, * right brachiocephalic vein, ★ right internal jugular vein, △ angle of right internal jugular vein and right subclavian vein.

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