Which scenario indicates central venous catheter use as vascular access may be appropriate?

• A. When patient has robust peripheral veins
• B. When fistula creation is planned
• C. When patient has inadequate blood vessels in the limbs
• D. When dialysis is not required

Answer: (C)

Central venous catheters are used when there are no suitable peripheral blood vessels to support a durable dialysis access. If a patient has inadequate blood vessels in the limbs, creating an arteriovenous fistula or graft may not be feasible, so a central venous catheter provides immediate vascular access for dialysis via a central vein (such as internal jugular or subclavian). This option is often chosen as a bridge to longer-term access or when urgent dialysis is needed and there isn’t time or suitable anatomy for a fistula. It’s not chosen when the patient has robust peripheral veins because a fistula or graft is preferred for long-term use, and not used if dialysis isn’t required. Catheters, while useful, carry higher infection and thrombosis risks and are typically viewed as temporary or bridging access rather than a long-term solution.