Fluoroscopy overestimates the cavoatrial junction position. Given that right atrium placement reduces intrathoracic central venous stenosis risk, advancing the catheter tip 10-30 mm beyond fluoroscopically guided landmarks constitutes a key maneuver for achieving accurate positioning. Implementation of this optimization strategy is associated with a 5.78-fold reduction in odds of intrathoracic central venous stenosis, providing actionable optimization for hemodialysis access management.
Fen et al. (2026) studied this question.