@thevascularguy: Full Procedure: https://f.mtr.cool/refkbdlqlu Precision is everything! After safely avoiding a collateral vessel, it's time to pitch the needle back up towards the IJ to complete the puncture safely. This was a difficult bedside tunneled central venous catheter insertion because of the EJ (External Jugular) vein in the way of the subcutaneous tunnel. Another factor that made this difficult was the 1cm deeper collateral vessel under the EJ. I navigated the introducer needle in between the EJ and collateral vein under ultrasound guidance to puncture the IJ (Internal Jugular) vein. The angiocath was difficult to puncture the IJ causing endothelial drag. #vascularaccess #TVG #nurse #doctor #butteflynetwork iq+ ultrasound probe was used for this procedure