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. 2024 Dec 13;13(24):7579.
doi: 10.3390/jcm13247579.

Risk Factors for Internal Jugular Vein Thrombosis 1 Month After Non-Cuffed Hemodialysis Catheter Removal

Shun Yoshida  1   2 , Yasuyo Sato  1   2 , Tsukasa Naganuma  1 , Ikuo Nukui  1 , Masakiyo Wakasugi  1 , Ayumu Nakashima  2
Affiliations

Risk Factors for Internal Jugular Vein Thrombosis 1 Month After Non-Cuffed Hemodialysis Catheter Removal

Shun Yoshida et al. J Clin Med. .

Abstract

Background: Complications, namely, catheter-related thrombosis (CRT) and venous stenosis, are associated with non-cuffed hemodialysis catheters used for emergency vascular access. However, only a few reports have demonstrated changes in the venous lumen and intravenous thrombosis after catheter removal. In this study, we comprehensively investigated the risk factors for residual thrombus 1 month after hemodialysis catheter removal. Methods: This prospective observational study was conducted from June 2021 to October 2022. We included patients with end-stage kidney disease who underwent hemodialysis catheter placement in the internal jugular vein (IJV). After catheter removal, we observed the IJV using vascular ultrasound and evaluated the thrombus and vein properties. Furthermore, we observed thrombosis 1 month after catheter removal, and investigated the risk factors for residual thrombus 1 month after catheter removal. Results: A thrombus was observed at the site of catheter removal in all the cases. Of the 37 patients who were followed up, 11 exhibited a residual thrombus 1 month after catheter removal. Patients with arteriovenous (AV) access dysfunction and enlarged lymph nodes during catheter removal were significantly more likely to have a residual thrombus 1 month after catheter removal. These associations remained significant even after adjusting for age, sex, and diabetes status. Conclusions: In 29.7% of the patients, CRT persisted even 1 month after the removal of the non-cuffed hemodialysis catheter. The provision of early intervention in patients with AV access dysfunction and enlarged lymph nodes during catheter removal may prevent CRT persistence.

Keywords: lymphadenopathy; non-tunneled catheter; temporary catheter.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Ultrasonographic images of a normal IJV (transverse section). IJV, internal jugular vein; CCA, common carotid artery.
Figure 2
Figure 2
Ultrasonographic images of an IJV thrombus (arrows) confirmed after catheter removal. (a): transverse section; (b): color Doppler imaging; (c): longitudinal section. Color Doppler imaging shows blood flow outside the thrombus. IJV, internal jugular vein.
Figure 3
Figure 3
Various thrombus shapes (arrows). (a,b) Fibrin sheath (FS) is a thrombus that appears as a cord-like structure. (c,d) Images show FS with mural thrombus. (e,f) Images show thrombus filling and occluding the IJV. Color Doppler images show no blood flow in the IJV. An enlarged lymph node (arrowhead) near the obstructed IJV was also observed. IJV, internal jugular vein; CCA, common carotid artery.
Figure 3
Figure 3
Various thrombus shapes (arrows). (a,b) Fibrin sheath (FS) is a thrombus that appears as a cord-like structure. (c,d) Images show FS with mural thrombus. (e,f) Images show thrombus filling and occluding the IJV. Color Doppler images show no blood flow in the IJV. An enlarged lymph node (arrowhead) near the obstructed IJV was also observed. IJV, internal jugular vein; CCA, common carotid artery.
See this image and copyright information in PMC

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