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Title: Central Venous Access

Abstract

Central venous access plays an important role in the management of an ever-increasing population of patients ranging from those that are critically ill to patients with difficult clinical access. Interventional radiologists are key in delivering this service and should be familiar with the wide range of techniques and catheters now available to them. A comprehensive description of these catheters with regard to indications, technical aspects of catheterization, success rates, and associated early and late complications, as well as a review of various published guidelines on central venous catheter insertion are given in this article.

Authors:
; ;  [1]
  1. John Radcliffe Hospital, Department of Radiology (United Kingdom), E-mail: raman.uberoi@orh.nhs.uk
Publication Date:
OSTI Identifier:
21091055
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 30; Journal Issue: 1; Other Information: DOI: 10.1007/s00270-006-0021-z; Copyright (c) 2007 Springer Science+Business Media, Inc.; www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; PATIENTS; RECOMMENDATIONS; REVIEWS; VASCULAR DISEASES

Citation Formats

Ganeshan, Arul, Warakaulle, Dinuke R., and Uberoi, Raman. Central Venous Access. United States: N. p., 2007. Web. doi:10.1007/S00270-006-0021-Z.
Ganeshan, Arul, Warakaulle, Dinuke R., & Uberoi, Raman. Central Venous Access. United States. doi:10.1007/S00270-006-0021-Z.
Ganeshan, Arul, Warakaulle, Dinuke R., and Uberoi, Raman. Thu . "Central Venous Access". United States. doi:10.1007/S00270-006-0021-Z.
@article{osti_21091055,
title = {Central Venous Access},
author = {Ganeshan, Arul and Warakaulle, Dinuke R. and Uberoi, Raman},
abstractNote = {Central venous access plays an important role in the management of an ever-increasing population of patients ranging from those that are critically ill to patients with difficult clinical access. Interventional radiologists are key in delivering this service and should be familiar with the wide range of techniques and catheters now available to them. A comprehensive description of these catheters with regard to indications, technical aspects of catheterization, success rates, and associated early and late complications, as well as a review of various published guidelines on central venous catheter insertion are given in this article.},
doi = {10.1007/S00270-006-0021-Z},
journal = {Cardiovascular and Interventional Radiology},
number = 1,
volume = 30,
place = {United States},
year = {Thu Feb 15 00:00:00 EST 2007},
month = {Thu Feb 15 00:00:00 EST 2007}
}
  • This report describes a technique of inserting an implantable venous access port (portacath) through a thrombosed and occluded vein employing a pre-existing peripherally inserted central catheter (PICC) as the route of access. The PICC was used as a conduit for venous access in a way that has not been described previously in the literature. This procedure was performed in a young patient with cystic fibrosis in an effort to prevent the use of his virgin contralateral veins, which might be used in the future.
  • No abstract prepared.
  • Purpose: We describe the technique, efficacy, and complications of fluoroscopy-guided implantation of a central venous access device using a peripherally accessed system (PAS) port via the forearm. Methods: Beginning in July 1994, 105 central venous access devices were implanted in 104 patients for the long-term infusion of antibiotics or antineoplasmic agents, blood products, or parenteral nutrition. The devices was inserted under fluoroscopic guidance with real-time venography from a peripheral route. Results: All ports were successfully implanted. There were no procedure-related complications. No thrombosis or local infection was observed; however, in six patients catheter-related phlebitis occurred. Conclusion: Fluoroscopy-guided implantation of amore » central venous access device using a PAS port via the forearm is safe and efficacious, and injection of contrast medium through a peripheral IV catheter before introduction of the catheter helps to avoid catheter-related phlebitis.« less
  • Purpose: To assess safety and function of central venous port systems implanted percutaneously in the interventional radiology suite.Methods: One hundred and twenty-five consecutive ports in 123 patients were evaluated retrospectively. One hundred and twenty ports were implanted via the subclavian vein.Results: Technical success was 100%. Fourteen patients (11.2%) experienced immediate procedural complications, all minor (pneumothorax 1.6%). During follow-up (4-343 days, mean service period 97.8 days), nine complications occurred, six of which were major. These were three port infections which led to hospitalization and port removal, one chamber penetration through the skin, and two port occlusions. Port removal as a resultmore » of complications was performed in six patients. Altogether, 20 complications occurred within a total of 11,056 days of service, which means 1.8 events per 1000 days of service.Conclusion: Percutaneous implantation of central venous port systems is safe and easy to perform. Complication rates of this study compare favorably with those of other radiological and surgical series.« less
  • Purpose: Approximately 200,000 central venous catheterizations are carried out annually in the National Health Service in the United Kingdom. Inadvertent arterial puncture occurs in up to 3.7%. Significant morbidity and death has been reported. We report on our experience in the endovascular treatment of this iatrogenic complication. Methods: Retrospective analysis was carried out of 9 cases referred for endovascular treatment of inadvertent arterial puncture during central venous catheterization over a 5 year period. Results: It was not possible to obtain accurate figures on the numbers of central venous catheterizations carried out during the time period. Five patients were referred withmore » carotid or subclavian pseudoaneurysms and hemothorax following inadvertent arterial catheter insertion and subsequent removal. These patients all underwent percutaneous balloon tamponade and/or stent-graft insertion. More recently 4 patients were referred with the catheter still in situ and were successfully treated with a percutaneous closure device. Conclusion: If inadvertent arterial catheterization during central venous access procedures is recognized and catheters removed, sequelae can be treated percutaneously. However, once the complication is recognized it is better to leave the catheter in situ and seal the artery percutaneously with a closure device.« less