Percutaneous Placement of a Tunneled Permanent Hemodialysis Catheter via the Right Internal Thoracic Vein in a Patient with Exhausted Vascular Access

A 30-year-old patient with end-stage chronic kidney disease presented in critical condition due to the exhaustion of vascular access options and recurrent episodes of peritonitis precluding peritoneal dialysis. A percutaneous, tunneled hemodialysis catheter was successfully placed via the right internal thoracic vein, providing life-saving vascular access and enabling immediate initiation of renal replacement therapy.