US-guided placement of temporary internal jugular vein catheters: immediate technical success and complications in normal and high-risk patients

Eur J Radiol. 2005 Jul;55(1):125-9. doi: 10.1016/j.ejrad.2004.10.004. Epub 2004 Nov 18.

Abstract

Objective: To evaluate the technical success and immediate complication rates of temporary internal jugular vein (IJV) haemodialysis catheter placement in normal and high-risk patients.

Methods and materials: Two-hundred and twenty temporary internal jugular vein catheters inserted under ultrasound guidance in 172 patients were prospectively analyzed. Of 172 patients, 93 (54%) were males and 79 (46%) were females (age range, 18-83; mean, 56.0 years). Of 220 catheters, 171 (78%) were placed in patients who had a risk factor for catheter placement like patients with disorder of haemostasis, poor compliance, and previous multiple catheter insertion in the same IJV. Forty-seven (21.3%) procedures were performed on bed-side. A catheter was inserted in the right IJV in 178 procedures (80.9%) and left IJV in 42 procedures. Of 172 patients, 112 (65%) had only one catheter placement and the rest had had more than one catheter placement (range, 1-5).

Results: Technical success was achieved in all patients (100%). Average number of puncture was 1.24 (range, 1-3). One hundred and eighty-three insertions (83.1%) were single-wall punctures, whereas 37 punctures were double wall punctures. Nine (4%) minor complications were encountered. Inadvertent carotid artery puncture without a sequel in four procedures (1.8%), oozing of blood around the catheter in three procedures (1.4%), a small hematoma in one procedure (0.4%), and puncture through the pleura in one procedure (0.4%) without development of pneumothorax. Oozing of blood was seen only in patients with disorder of haemostasis.

Conclusion: Ultrasound-guided placement of internal jugular vein catheters is very safe with very high success rate and few complications. It can safely be performed in high-risk patients, like patients with disorders of haemostasis and patients with previous multiple catheter insertion in the same vein.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / methods*
  • Female
  • Humans
  • Jugular Veins / diagnostic imaging*
  • Male
  • Middle Aged
  • Prospective Studies
  • Punctures
  • Renal Dialysis / instrumentation*
  • Treatment Outcome
  • Ultrasonography, Interventional*