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A case of ESRD on HD who is referred for placement of tunnel hemodialysis catheter insertion because his arterial-venous fistula is still immature to be used for HD. He had had 3 TDC placed in the right IJ on previous occasions. His angiogram revealed stenosis of the internal jugular vein at its junction with subclavian vein. After 3 failed attempts at right internal jugular vein cannulation the Supraclavicular approach of the SCV cannulation was achieved with ease overcoming the stenosis in the right internal jugular vein.

annals of nephrology

Revival of the Forgotten Rout: Tunnel Hemodialysis Catheter Placement using the Supraclavicular Approach to Overcome Stenosis of the Internal Jugular vein at its Origin