title: Safety and efficacy of placing internal jugular dialysis catheter tip in the inferior vena cava.
abstract: OBJECTIVE
  To assess the efficacy and safety of placing the tip of the internal jugular (IJ) hemodialysis catheter in the inferior vena cava (IVC) in situations where it does not work well when placed in the right atrium.
  
  
  METHODS
  The medical records of chronic hemodialysis patients at an outpatient vascular intervention facility were retrospectively reviewed. Out of the 831 patients who had dialysis catheters exchanged over a 4-year period, 13 patients were identified who underwent catheter exchanges where the tip of the catheter was placed in the IVC via the IJ approach. These were all patients where the catheters had poor flows when placed in the right atrium earlier.
  
  
  RESULTS
  Adequate flow (&gt;350 mL/min) was achieved in all 13 cases with the catheter placed in the IVC with no significant complications.
  
  
  CONCLUSIONS
  This study suggests that exchanging the catheter and placing the tip in the IVC is effective and safe in certain situations especially when the tip placement in the conventional position (i.e. the right atrium) does not work well.
authors.affiliation:  Duke University, Durham, North Carolina - USA.
authors.forename: Michael A M
authors.initials: MA
authors.lastname: Mayer
authors.affiliation:  University of Illinois College of Medicine, Chicago, Illinois - USA.
authors.forename: Vinaya
authors.initials: V
authors.lastname: Soundararajan
authors.affiliation:  Midwestern University Medical School, Chicago, Illinois - USA.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Soundararajan
mesh_terms: D001783:Blood Flow Velocity; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002408:Catheters, Indwelling; D062905:Central Venous Catheters; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging; D010690:Phlebography; D012039:Regional Blood Flow; D012189:Retrospective Studies; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging