Implantation of Hemodialysis Catheter in the Iliac Vein vs. Placement in Femoral Vein with Ultrasound Guidance

Background: We compare the results of implantation of hemodialysis catheter in the iliac vein versus placement in femoral vein both guided with ultrasound, analyzing complications, technique and survival Methods: All patients required chronic hemodialysis and to who were determined not to place a catheter in the internal jugular vein, femoral with history of multiple vascular access, AV fistula or grafts where it was essential to obtain an alternative vascular access. When the procedure for the insertion for the iliac vascular access was realized was always with US guidance. The results were compared with patients who underwent the implantation of a tunneled vascular access in the femoral region Results: The insertion of catheters were realized by the nephrologists experts in vascular access from the HGR 46 of the IMSS in Guadalajara, Jalisco, Mexico, between 2021-2024. A total of 12 iliac catheters were implanted all with US guidance. The iliac catheter group had the same amount of punctures as the femoral catheter group, arterial punctures were rare in both techniques. No differences were observed in complications related to the procedures. Conclusion: Implantation of iliac catheters in patients with impossibility for conventional site insertion is a safe procedure and feasible in patients with vascular exhaustion. The rate of complications and survival was not inferior to the femoral catheter group. It is necessary to know the inguinal region anatomy as well as the correct selection of patients.