Unconventional central access: catheter insertion in collateral or in recanalized veins.

Catheter hemodialysis is an unfortunate but necessary option for patients with end-stage kidneys. Patients on chronic catheter hemodialysis often slowly exhaust veins in the neck and chest, necessitating use of unconventional veins such as the femoral veins, translumbar inferior vena cava, hepatic veins, or recanalized or collateral veins. Recanalized or collateral veins are an attractive option because using these veins preserves the limited remaining access sites. Patients favor this approach because catheter care is simplified; catheters inserted in these veins appear identical to catheters inserted in the internal or external jugular veins.