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Apsner R, Sunder-Plassman G, Muhm M, Druml W
Alternative puncture site of implantable permanent hemodialysis catheters
Nephrol Dial Transplant (Nov) 11:2293-2295 1996
This paper describes the use of a method of jugular vein catheterization first proposed by Rao (Anesthesiology 46:362-364, 1977) which uses an insertion point just above the clavicle and 0.5 cm lateral to the insertion of the sternal head of the sternocleidomastoid muscle. It was used in 4 cases with previous vascular injury or scarring, after previous subclavian attempts had failed, but attempt to place catheters using more standard IJ approaches had not apparently been tried. The method should not be used on the left side because of danger of puncture of the thoracic duct.
Comment: The indications for this low approach to the jugular vein are not clear. Possibly it should be used when there is associated stenosis of the jugular vein. (John T. Daugirdas, M.D., University of Illinois at Chicago)
The full text of this abstract is available from Oxford Press at this site.
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