Right versus left internal jugular vein catheterization for hemodialysis: complications and impact on ipsilateral access creation.

This study investigated whether the anatomical differences between right and left internal jugular vein catheterization (RJVC and LJVC) would lead to differences in the frequency of complications, in particular, central vein occlusion (CVO). A group of 479 jugular vein catheterizations, 403 RJVC and 77 LJVC done in 294 prevalent hemodialysis patients were analyzed. A right-sided carotid pseudoaneurysm was the only major puncture-related complication. A total of 78 RJVC and 17 LJVC were inserted more than once in the same position. Of the RJVC, 44 (10.9%) of 403 were removed because of infection compared with 16 (20.8%) of 77 LJVC (P < 0.02). The overall incidence of infections was 1.58 episodes of infection per 1000 catheter days, 1.57 for RJVC and 3.72 for LJVC, respectively. Catheter dwell times were not different. A group of 127 patients with former RJVC and 44 with LJVC had ipsilateral arteriovenous access (RJVC+ and LJVC+ group, respectively). Four diabetic LJVC+ developed severe arm swelling secondary to CVO leading ultimately to access ligation. The RJVC+ group had no access ligated. LJVC may cause CVO in diabetics.