[Positioning of hemodialysis catheters after locating the internal jugular vein by echo-Doppler].

Despite significant progress, vascular access remains a major concern for nephrologists. For the last 6 years we have used as temporary vascular access silastic twin catheters implanted into the internal jugular vein based on Canaud's method. We have developed in 15 patients an ultrasound-guided method using an ultrasonic Doppler to improve access to the internal jugular vein, prior to its catheterization. Ultrasound assistance was provided by a 5MHz mechanical sectorscanning transducer (Toshiba 270A). The internal jugular vein and carotid artery were visualized. The skin overlying the internal jugular vein was marked with indelebile ink. The internal jugular vein was cannulated successfully in 14 patients. The use of ultrasound guidance to cannulate the internal jugular vein improves success, and reduces complications. This method is recommended in patients with distorted cervical or subclavicular anatomic characteristics, or with bleeding tendency.