Outcomes of success rates and complications in ultrasound-guided tunneled hemodialysis catheter placement via the right internal jugular vein

Aims: The selection of optimal vascular access is crucial for chronic hemodialysis (HD) patients, with arteriovenous fistulas (AVFs) recommended as the first-line option. However, in cases where AVFs are not viable, tunneled hemodialysis catheters (THCs) provide a reliable alternative. This study aimed to evaluate the technical success rates and both short- and long-term complications associated with THCs placed via the right internal jugular vein (IJV) under ultrasound (US) guidance. Methods: In this retrospective study, 160 patients with end-stage renal disease (ESRD) underwent THC placement via the right IJV using US and fluoroscopic guidance between September 2022 and September 2024. Demographic data, catheter placement details, and post-procedural outcomes were obtained from the hospital records and analyzed. Catheter dysfunction, defined by failure to maintain adequate blood flow or dialysis efficiency, was monitored, as were complications such as infection, thrombosis, and fibrin sheath formation. Results: A total of 226 catheters were placed in 160 patients with a technical success rate of 99%. The first-attempt success rate under US guidance was 89%, with minor complications observed in only 7% of procedures. Long-term follow-up (average of 196 days) indicated that venous thrombosis occurred in 2 patients, venous stenosis in 4 patients, and fibrin sheath formation in 3 patients. Catheter dysfunction led to replacement in 29 patients, with further interventions required in 12 cases. No major complications, such as pneumothorax or significant bleeding, were observed. Conclusion: THCs placed via the right IJV under US guidance achieved high technical success rates and low complication rates, supporting their efficacy and safety for long-term use in HD patients. The findings align with current literature on the benefits of US guidance in reducing complications and improving procedural success. Given the study's retrospective and single-center limitations, additional research with larger, multicenter cohorts is recommended to validate these results and optimize catheter placement practices for high-risk patients.