“…Different guidewires can also be placed in the pigtail to adjust stiffness as needed (not shown) Catheter tip position has been reported to be a precipitating factor for catheter dysfunction [4,14,15]. Catheter tips that are located in the brachiocephalic vein or the upper part of SVC have been associated with a greater rate of dysfunction [14,16,17]. Every case in our series that required additional maneuvers, such as mechanical adhesiolysis, presented with a catheter tip located in a suboptimal position, most commonly in the innominate vein or the upper third of the SVC.…”