Superiority of the Internal Jugular over the Subclavian Access for Temporary Dialysis

TLDR

The two groups were statistically similar in age, sex, and race. We angiographically examined the access route 1–27 months after insertion of temporary dialysis catheters in 52 patients (32 subclavian, 20 internal jugular). Internal jugular catheters were left longer (15.8 vs 11.5 days) and showed no venogram abnormalities, whereas subclavian catheters had a 50 % stricture rate with 90 % severe occlusion, resulting in a markedly higher long‑term stricture rate.

Abstract

We studied angiographically the access route 1–27 months after the insertion of temporary dialysis catheters in 52 patients: 32 subclavian and 20 internal jugular. The two groups were statistically similar with respect to age, sex and race. The subclavian catheters were left in for a mean of 11.5 days (2–22) while the internal jugular ones were inserted for 15.8 days (5–25; p = 0.0015). One hundred percent of the internal jugular patients were free of any venogram abnormalities in their venous access return. In marked contrast, 50% of the subclavian sites had mild to severe strictures with 90% having 70–100% occlusion of the subclavian vein. Six patients had bilateral severe strictures. The long-term stricture rate of subclavian catheters in the subclavian vein was unacceptably high compared to the internal jugular route.