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Internal Jugular Vein Thrombosis Associated with Hemodialysis Catheters¹

¹ From the Departments of Radiology (T.D.W., S.O.T.), Medicine-Nephrology (M.A.K.), and Medicine-Biostatistics (K.A.L.), Indiana University School of Medicine, Indianapolis. Received June 7, 2002; revision requested August 9; revision received October 25; accepted January 8, 2003. Supported by a grant from Bard Access Systems, Salt Lake City, Utah. Address correspondence to S.O.T., Department of Radiology, Hospital of the University of Pennsylvania, 1 Silverstein, 3400 Spruce St, Philadelphia, PA 19104 (e-mail: streroto@uphs.upenn.edu).

PURPOSE: 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.

MATERIALS AND METHODS: 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 ² tests.

RESULTS: 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.

CONCLUSION: 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.

© RSNA, 2003

Index terms: Catheters and catheterization, complications, 907.442, 9462.442 • Dialysis, 81.42 • Veins, access, 907.1269, 9462.1269 • Veins, thrombosis, 907.442, 9462.442 • Veins, transluminal angioplasty, 907.1269, 9462.1269

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