Internal jugular vein thrombosis associated with hemodialysis catheters

To determine the prevalence of internal jugular vein thrombosis among patients undergoing hemodialysis in whom tunneled dialysis catheters were placed by interventional radiologists and to evaluate potential risk factors for thrombosis, such as the number of catheters inserted per patient through the right internal jugular vein, catheter type and material, total catheter days, and catheter-associated infection.

Ultrasonographic (US) evaluation of the right internal jugular vein was performed by interventional radiologists in 143 patients with a history of dialysis catheter placement. The examination focused on the detection of right internal jugular vein thrombosis, with or without occlusion. Total catheter days, catheter type, and catheter-related complications, most notably infection, were evaluated with database analysis for possible association with subsequent development of thrombosis. Statistical analysis of potential risk factors was performed with logistic regression models and chi2 tests.

Evidence of right internal jugular vein thrombosis was present in 25.9% of the patients enrolled in the study. Among the veins with thrombosis, 62% were occluded. Only the mean number of catheters placed in the right internal jugular vein per patient was significant below the level of P =.20; therefore, a multivariate logistic regression model was not used.

Prevalence of internal jugular thrombosis, both complete and incomplete, was higher in the study population than previously reported. The risk factors that were analyzed demonstrated no statistically significant association with development of thrombosis.