Difficult Internal Jugular Central Venous Cannulation Using J-Tip Guidewire with Indwelling Peripherally Inserted Central Venous Catheters

Figure 1

Chest X-ray showing multiple superficial EKG electrodes, left upper extremity PICC line with RIJ central venous catheter optimally positioned at right atrium and SVC junction, importantly with 45-degree angle at convergence.