How I do it: Preferential use of the right external jugular vein for tunneled catheter placement

We describe a case in which the right external jugular vein (REJ) was preferentially used to place a tunneled catheter, even though the left internal jugular vein (LIJ) was widely patent. The possible advantage of placing REJ catheters over LIJ is that doing so may function to preserve better the left-sided vasculature in general, and, in particular, when future left-sided access is planned. Contrast venography was required. While REJ is a viable option for catheter insertion, the effect of REJ vs. LIJ catheter placement on long-term vessel patency as well as catheter function must be more rigorously defined to conclusively establish the superiority of one over the other. We describe a case in which the right external jugular vein (REJ) was preferentially used to place a tunneled catheter, even though the left internal jugular vein (LIJ) was widely patent. The possible advantage of placing REJ catheters over LIJ is that doing so may function to preserve better the left-sided vasculature in general, and, in particular, when future left-sided access is planned. Contrast venography was required. While REJ is a viable option for catheter insertion, the effect of REJ vs. LIJ catheter placement on long-term vessel patency as well as catheter function must be more rigorously defined to conclusively establish the superiority of one over the other.