Unconventional central access: catheter insertion in collateral or in recanalized veins

Area of Science:

• Nephrology
• Vascular Access

Background:

• Catheter hemodialysis is essential for end-stage kidney disease (ESKD) management.
• Patients undergoing chronic hemodialysis frequently deplete accessible neck and chest veins.
• This necessitates the exploration of alternative venous access sites.

Purpose of the Study:

• To evaluate the utility of recanalized or collateral veins for hemodialysis catheter placement.
• To highlight the benefits of using these unconventional veins in ESKD patients.

Main Methods:

• Review of cases involving hemodialysis catheter placement in recanalized or collateral veins.
• Comparison of outcomes and patient experience with traditional venous access.

Main Results:

• Recanalized or collateral veins serve as a viable alternative when primary sites are exhausted.
• Utilizing these veins preserves critical, limited remaining access sites.
• Catheter management in these veins is simplified and clinically similar to conventional internal jugular catheters.

Conclusions:

• Recanalized and collateral veins represent an important strategy for maintaining long-term hemodialysis access.
• This approach enhances patient care by preserving access options and simplifying catheter maintenance.