Bedside Placement of Right Internal Jugular Tunneled Dialysis Catheters by Nephrologists Without Fluoroscopy: Safety and Outcomes From a Retrospective Single-Center Study

IF 1.4 4区医学 Q3 UROLOGY & NEPHROLOGY

Hemodialysis International Pub Date : 2026-10-05 Epub Date: 2026-06-14 DOI:10.1111/hdi.70097

Ganesh Srinivasa Prasad P, Aravind Sarvepalli, Limesh M, Vinod Nagesh, Nitin Kumar Hegde

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引用次数: 0

Abstract

Background

Guidelines recommend fluoroscopic guidance for tunneled hemodialysis catheter placement, but fluoroscopy is costly, not universally available, and increases patient radiation exposure. Ultrasound-guided bedside placement by nephrologists, using anatomical landmarks, may provide a safe and cost-effective alternative. To evaluate the immediate safety and outcomes of nonfluoroscopic right internal jugular vein tunneled catheter placement performed by nephrologists in a tertiary care center.

Methods

Conducted a retrospective analysis of all tunneled dialysis catheters placed bedside at our center between January 2021 and December 2022. Ultrasound was used for venous cannulation, anatomical landmarks for surface marking, and postprocedure chest radiography for tip confirmation. The primary outcome was procedure-related complications within 24 h. Access failure, defined as the inability to use the catheter for dialysis within 24 h, was the secondary outcome.

Results

Among 235 patients (77.4% male; mean age 55.8 years), 7 (2.9%) developed immediate complications. Minor exit-site bleeding occurred in four patients (1.7%), all managed conservatively; two received fresh frozen plasma. Catheter malposition occurred in two cases (0.85%); one required repositioning and the other replacement with a femoral catheter. One patient (0.4%) had a cardiac arrest attributed to acute coronary syndrome unrelated to the procedure. Access failure occurred in one case (0.4%). All remaining catheters functioned successfully for immediate dialysis.

Conclusion

Ultrasound-guided, nonfluoroscopic bedside placement of right internal jugular vein tunneled catheters by nephrologists is feasible, safe, and cost-effective. This technique reduces radiation exposure and costs, supporting its role in resource-limited settings. Prospective multicenter studies are warranted to assess long-term patency, infection rates, and dialysis adequacy.

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肾科医师床边放置右侧颈内管透析导管无需透视：安全性和单中心回顾性研究的结果

背景：指南推荐透视指导下放置隧道血液透析导管，但透视是昂贵的，不是普遍可用的，并增加患者的辐射暴露。超声引导床边放置肾脏学家，利用解剖标志，可能提供一个安全和经济的选择。评价三级保健中心肾科医师在非透视下行右颈内静脉隧道导管置入的即时安全性和结果。方法：回顾性分析2021年1月至2022年12月在我中心放置床边的所有隧道式透析导管。超声用于静脉插管，解剖标记用于表面标记，术后胸片用于尖端确认。主要结局是24小时内手术相关并发症。通道失败，定义为24小时内无法使用导管进行透析，是次要结局。结果：235例患者中，男性77.4%，平均年龄55.8岁，7例（2.9%）出现即刻并发症。4例患者发生轻微出口部位出血（1.7%），均采用保守治疗；其中两人接受了新鲜的冷冻血浆。导管错位2例（0.85%）；一个需要重新定位，另一个需要更换股导管。1例患者（0.4%）发生与手术无关的急性冠状动脉综合征引起的心脏骤停。1例（0.4%）访问失败。所有剩余的导管都成功进行了即时透析。结论：超声引导下，非透视下肾内科医师床边放置右颈内静脉隧道导管是可行、安全、经济的。这项技术减少了辐射暴露和成本，支持其在资源有限的环境中的作用。有必要进行前瞻性多中心研究来评估长期通畅、感染率和透析充分性。

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来源期刊

Hemodialysis International UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.