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

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.