Q: Which route is least preferable for putting central dialysis catheter in a patient presented with acute renal failure? - Choose one
A) Internal Jugular

B) Subclavian

C) Femoral

D) Axillary

E) Transhepatic



Answer: Subclavian

The internal jugular vein is the most preferred site due to its easy puncture and the low rate of complications. The subclavian route should be avoided if possible, since it results in high stenosis and thrombosis rates, which subsequently prevent the use of the upper extremity for the creation of A-V fistulas if needed. The femoral is another good choice for temporary measure with easy access but has disadvantage of a high thrombosis and infection rates.The axillary vein placement requires an experienced operator. Transhepatic is technically difficult and reserve for advance cases.