Mayer Michael A M, Soundararajan Vinaya, Soundararajan Ramesh
Duke University, Durham, North Carolina - USA.
University of Illinois College of Medicine, Chicago, Illinois - USA.
J Vasc Access. 2017 Jan 18;18(1):79-81. doi: 10.5301/jva.5000643. Epub 2017 Jan 3.
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.
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.
Adequate flow (>350 mL/min) was achieved in all 13 cases with the catheter placed in the IVC with no significant complications.
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.
评估在颈内静脉（IJ）血液透析导管尖端置于右心房效果不佳的情况下，将其置于下腔静脉（IVC）的有效性和安全性。
回顾性分析一家门诊血管介入机构慢性血液透析患者的病历。在4年期间接受透析导管更换的831例患者中，有13例患者通过IJ途径进行导管更换，导管尖端置于IVC。这些患者之前导管置于右心房时血流量均不佳。
13例导管置于IVC的患者均实现了充足的血流量（>350 mL/分钟），且无明显并发症。
本研究表明，在某些情况下，尤其是导管尖端置于传统位置（即右心房）效果不佳时，更换导管并将尖端置于IVC是有效且安全的。
