Search Our Scientific Publications & Authors

Pacing Clin Electrophysiol 2021 Apr 2;44(4):607-613. Epub 2021 Mar 2.

Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.

Background: Venous access for cardiac implantable electronic devices (CIED) is commonly performed by cephalic venous cut down, or axillary or subclavian vein puncture. The latter technique carries a risk of complications such as pneumothorax or lead crush. Cephalic venous cut down is free of these complications but often less successful due to technical difficulties. Read More

Surg Neurol Int 2021 28;12:32. Epub 2021 Jan 28.

Department of Neurosurgery, Hospital Central Sur de Alta Especialidad, Mexico City, Mexico.

Background: Thrombosis of the internal jugular vein (IJV) is extremely rare, being central catheterization the most common cause. We present a case of a patient with an unusual appearance of neurological symptoms as a consequence of thrombosis of the IJV secondary to miliary tuberculosis.

Case Description: A 30-year-old woman with disseminated tuberculosis, with multiple lymphadenopathy, axillary, cervical, mesenteric, retroperitoneal, and inguinal, presented with clinical evidence of intracranial hypertension. Read More

Complement Ther Med 2020 Aug 16;52:102448. Epub 2020 May 16.

Department of Integrated Chinese and Western Medicine, Yuhuangding Hospital Affiliated to Qingdao University, Yantai, 264000, China; Centre of Integrated Chinese and Western Medicine, School of Basic Medicine, Qingdao University, Qingdao, 266071, China. Electronic address:

Purpose: We aim to analyze the feasibility of external application of Xiao-Shuan-Santo prevent peripherally inserted central catheter (PICC) -related thrombosis.

Methods: A total of 218 patients with PICC catheterization were randomly divided into a control group (n = 103) and a treatment group (n = 115). Patients in the treatment group received additional external application of Xiao-Shuan-San. Read More

J Orthop Sports Phys Ther 2020 Sep;50(9):532

A 23-year-old, right hand-dominant, male active-duty Marine self-referred to physical therapy with dull right anterior shoulder pain. The physical therapist referred the patient for a diagnostic ultrasound to rule out effort thrombosis of the axillary and subclavian veins. Same-day Doppler ultrasonography revealed an occlusive thrombus in the middle subclavian and axillary veins. Read More

Cardiol Young 2020 Oct 11;30(10):1458-1461. Epub 2020 Aug 11.

Department of Paediatric Cardiology and Congenital Heart Disease, German Heart Centre Munich, Technische Universität München, München, Germany.

Background: Catheterization in small children should be performed with the lowest diameter introducer sheaths to prevent permanent vessel damage. The objective of this study is to evaluate the clinical safety and efficacy of the Glidesheath Slender in small children.

Methods And Results: We present a group of 52 patients (male: n = 36) with median age 118. Read More

Ann Intensive Care 2020 Jul 8;10(1):90. Epub 2020 Jul 8.

Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China.

Background: The present study aimed at comparing the success rate and safety of proximal versus distal approach for ultrasound (US)-guided axillary vein catheterization (AVC) in cardiac surgery patients susceptible to bleeding.

Methods: In this single-center randomized controlled trial, cardiac surgery patients susceptible to bleeding and requiring AVC were randomized to either the proximal or distal approach group for US-guided AVC. Patients susceptible to bleeding were defined as those who received oral antiplatelet drugs or anticoagulants for at least 3 days. Read More

J Vasc Access 2021 Mar 30;22(2):304-309. Epub 2020 Jun 30.

Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.

Some patients with intestinal failure, who are dependent on total parenteral nutrition for long periods, suffer from a lack of suitable conventional venous access points, including axillary, external jugular, internal jugular, subclavian, saphenous, and the brachio-cephalic and femoral veins, due to their occlusion. Furthermore, extensive central venous stenosis and/or thrombosis of the superior and inferior vena cava may preclude further catheterization, so uncommon routes must be used, which can be challenging. In such patients, the azygos vein via the intercostal vein is a viable candidate. Read More

Innovations (Phila) 2020 May/Jun;15(3):261-269. Epub 2020 May 21.

12235 158424 Department of Cardiothoracic Surgery, University of Miami Miller School of Medicine, FL, USA.

Objective: Operative techniques for minimally invasive cardiac surgery (MICS) have evolved dramatically over the past decade to include a wide demographic of patients. Mastering a variety of cannulation techniques is of paramount importance in performing a safe perfusion strategy and operation. Our aim is to describe cannulation strategies utilized in various MICS procedures. Read More

Intensive Crit Care Nurs 2020 Aug 3;59:102852. Epub 2020 Apr 3.

West China School of Nursing, Sichuan University, PO Box 610041, No. 37 Guo Xue Street, Chengdu, Sichuan Province, PR China; Department of Breast Surgery/Tumor Center, West China Hospital, Sichuan University, PO Box 610041, No. 37 Guo Xue Street, Chengdu, Sichuan Province, PR China.

Introduction: Central venous catheter applications and complications are closely related to the tip position. Previous studies have reported some rare cases of catheter misplacement. Here, we report a case of misplacement of a peripherally inserted central catheter into the lateral thoracic vein. Read More

Ann Vasc Surg 2020 Aug 28;67:563.e7-563.e11. Epub 2020 Mar 28.

Division of Vascular and Endovascular Surgery, Oregon Health & Science University, Portland, OR.

We present the case of an iatrogenic injury to the left subclavian artery during placement of a port for chemotherapy. The artery was inadvertently accessed at its infraclavicular position, and then was perforated centrally, entering the mediastinum at the origin of the left vertebral artery. Given that the patient's posterior circulation was largely dependent on the left vertebral artery, it could not be sacrificed. Read More

J Vasc Access 2020 Nov 1;21(6):854-860. Epub 2020 Mar 1.

Department of Emergency Medicine and Critical Care, The Affiliated Shanghai Songjiang Hospital of Nanjing Medical University, Shanghai, China.

Background: Ultrasound-guided axillary vein catheterization is now widely used in hospital, but it remains uncertain whether the distal axillary vein approach is more beneficial for seniors than the proximal axillary vein approach. This study aims to compare the puncture success rate and anatomical characteristics between these two approaches.

Methods: Senior patients requiring central venous catheterization were enrolled and randomized to the proximal axillary vein group ( = 49) or the distal axillary vein group ( = 50). Read More

J Vasc Access 2020 Sep 28;21(5):764-768. Epub 2020 Feb 28.

General Intensive Care Unit, Emergency Department, University of Milan-Bicocca, ASST Monza, San Gerardo Hospital, Monza, Italy.

Introduction: Midline catheters are widely used in clinical practice. Proper placement of midline catheter tip is usually assessed only by aspirating blood and flushing with normal saline without resistance.

Purpose: To describe the ultrasound-guided tip location for midline catheters and its feasibility and to compare incidence of catheter-related venous thrombosis associated with or without ultrasound tip localization. Read More

Minerva Anestesiol 2020 02 6;86(2):121-123. Epub 2019 Dec 6.

Intensive Care Unit, Department of Emergency, Anesthesiology and Intensive Care Medicine, "A. Gemelli" University Hospital Foundation IRCCS, Rome, Italy -

J Anesth 2020 04 30;34(2):167-186. Epub 2019 Nov 30.

Central venous catheterization is a basic skill applicable in various medical fields. However, because it may occasionally cause lethal complications, we developed this practical guide that will help a novice operator successfully perform central venous catheterization using ultrasound guidance. The focus of this practical guide is patient safety. Read More

J Cardiovasc Electrophysiol 2020 01 2;31(1):293-299. Epub 2019 Dec 2.

Division of Cardiology, Electrophysiology Section, University of Michigan, Ann Arbor, Michigan.

The standard technique for percutaneous catheter ablation of atrial fibrillation (AF) involves obtaining left atrial access and catheter manipulation from an inferior transfemoral venous access. However, in patients with inferior vena cava interruption, a standard transfemoral venous approach is not possible. In these cases, a percutaneous approach from a superior central vein, such as the internal jugular vein or the axillary/subclavian vein can be considered. Read More

Interv Cardiol Clin 2020 01 21;9(1):41-52. Epub 2019 Oct 21.

Division of Cardiology, University of Washington, 1959 Northeast Pacific Street Box 356422, Seattle, WA 98195, USA. Electronic address:

This article highlights the advantages and disadvantages of transradial arterial (TRA) access for a variety of presentations including acute coronary syndromes; cardiogenic shock; unprotected left main, heavily calcified coronaries; bifurcations; and chronic total occlusions. It includes techniques for overcoming challenges of using TRA access, including spasm and the need for larger bore guides. In addition, the authors review the use of ultrasound for access, percutaneous hemodynamic support via axillary approach, and tips and tricks to performing right heart catheterizations from the antecubital vein. Read More

Medicine (Baltimore) 2019 Nov;98(46):e18007

Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Long-term venous access is usually required in patients receiving chemotherapy. We hypothesized that, out of the various central line approach techniques, the cephalic vein cut-down technique can be a safe and simple alternative in terms of surgical safety, feasibility, cost-effectiveness, and functional outcomes.We retrospectively reviewed the medical records of 569 patients who underwent implantable central venous access between January 2012 and December 2014 at our hospital. Read More

Clin Radiol 2020 02 8;75(2):158.e1-158.e7. Epub 2019 Nov 8.

Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University, 1 Jianshe E Rd, Erqi Qu, Zhengzhou Shi, Henan Sheng, PR China.

Aim: To evaluate the safety and clinical efficacy of interventional treatment for arterial injury during blind, central venous catheterisation in the upper thorax at two tertiary medical centres.

Materials And Methods: Eighteen consecutive patients (37-81 years; M:F=8:10) who underwent interventional treatment for the arterial injuries that occurred during central venous catheterisation without any imaging guidance between November 2007 and December 2018 were included. Clinical data, angiographic findings, detailed interventional procedures, and technical and clinical outcomes were analysed retrospectively. Read More

Innovations (Phila) 2019 Nov/Dec;14(6):553-557. Epub 2019 Sep 11.

Department of Cardiac Anaesthesia, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, Karnataka, India.

Objective: To evaluate the safety and reproducibility of modified right vertical infra axillary thoracotomy (RVIAT) for repair of sinus venosus defects with right-sided partial anomalous pulmonary venous connection (PAPVC) in children.

Methods: Between March 2017 and February 2018, we performed intracardiac repair for sinus venosus defects with right-sided PAPVC in 14 children through modified RVIAT. Median age and weight were 9. Read More

J Vasc Access 2020 Mar 26;21(2):210-216. Epub 2019 Aug 26.

Department of Anesthesiology & Critical Care, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed-to-be University), Puducherry, India.

Background: Abduction of the arm has been used for ultrasound-guided infraclavicular axillary vein cannulation. We evaluated the influence of arm position on sonographic visualization and cannulation of the axillary vein in patients receiving mechanical ventilation.

Methods: Sixty patients scheduled to undergo surgery under general anaesthesia with controlled mechanical ventilation were included in this prospective randomized study. Read More

Ann Vasc Surg 2019 Nov 31;61:356-362. Epub 2019 Jul 31.

2nd Department of Vascular Surgery and Angiology, Medical Centre of Postgraduate Education, Warsaw, Poland.

Background: Achieving well-functioning dialysis fistulas is a common problem in dialyzed patients, and it is mainly caused by the pathologies of vessels used for fistula creation. Hybrid therapies, combining surgical and endovascular procedures, potentially enable the creation of functional dialysis fistulas in patients with vessels that are otherwise unsuitable for vascular access.

Methods: Between January 1, 2014 and June 30, 2018, we created dialysis fistulas simultaneously with endovascular correction of outflow pathologies in 15 patients. Read More

J Cardiovasc Electrophysiol 2019 09 23;30(9):1588-1593. Epub 2019 Jul 23.

Cardiology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.

Introduction: The most widespread venous sites of access for implantation intravenous implantable cardiac electronic device (CIED) are the cephalic and subclavian vein. Fluoroscopy-guided axillary venous access is an alternative, but efficacy and safety have not been studied under equal conditions. The aim of the present study is to compare the efficacy and safety of fluoroscopy-guided axillary vs cephalic vein access in CIED implant. Read More

J Surg Res 2019 12 11;244:296-301. Epub 2019 Jul 11.

Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.

Background: Central venous ports placed for breast cancer treatment have traditionally been placed contralateral to the disease. This is done out of concern for the possibility of an increased risk of complications with ipsilateral port placement. There have been only a few small studies evaluating complication rates between ports placed ipsilateral versus contralateral to the breast cancer. Read More

Minerva Anestesiol 2020 Feb 4;86(2):157-164. Epub 2019 Jul 4.

Department of Anesthesia, Critical Care and Emergency, Maggiore Polyclinic Hospital, Ca' Granda IRCCS and Foundation, University of Milan, Milan, Italy.

Background: Central venous catheterization is essential for careful administration of fluids and drugs in cardiac critical care patients. The axillary vein might represent an alternative to subclavian and jugular vein accesses, with the advantage of being extra-thoracic, more distal from the pleural space and with more likehood of comfort for the patient. Conventional ultrasound-guided cannulation of the axillary vein is technically demanding and does not guarantee precise visualization of the needle tip. Read More

J Vasc Access 2020 Jan 16;21(1):66-72. Epub 2019 Jun 16.

Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.

Introduction: The ultrasound-guided axillary vein is becoming a compulsory alternative vessel for central venous catheterization and the anatomical position offers several potential advantages over blind, subclavian vein techniques.

Objective: To determine the degree of dynamic variation of the axillary vein size measured by ultrasound prior to the induction of general anesthesia and after starting controlled mechanical ventilation.

Design: Prospective, observational study. Read More

J Vasc Nurs 2019 Jun 8;37(2):132-134. Epub 2019 Jan 8.

Department of Nursing, Professor of Nurse Anesthesiology and Vascular Access, National and Kapodistrian University of Athens, Athens, Greece. Electronic address:

Tunneled peripherally inserted central catheters (PICCs) offer several advantages such as an exit site at the green zone no matter where the puncture point is and a long subcutaneous route, which is considered a shield against infections and provides comfort to the patient. Clinicians could choose the proper exact exit site so as to avoid blood leakage from the exit point. The aim of the study was to assess the value of the tunneled PICCs versus normal PICCs with no long subcutaneous route. Read More

Ann Card Anaesth 2019 Apr-Jun;22(2):177-186

Department of Anaesthesiology, Fortis Hospital, Mumbai, Maharashtra, India.

Background: Ultrasound (US)-guided internal jugular vein (IJV) cannulation is a widely accepted standard procedure. The axillary vein (AV) in comparison to the subclavian vein is easily visualized, but its cannulation is not extensively studied in cardiac patients.

Aims: This study is an attempt to study the efficacy of real-time US-guided axillary venous cannulation as a safe alternative for the time-tested US-guided IJV cannulation. Read More

J Vasc Access 2019 Nov 28;20(6):630-635. Epub 2019 Mar 28.

Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai, China.

Background: Catheterization of the axillary vein in the infraclavicular area has important advantages in patients with long-term, indwelling central venous catheters. The two most commonly used ultrasound-guided approaches for catheterization of the axillary vein include the long-axis/in-plane approach and the short-axis/out-of-plane approach, but there are certain drawbacks to both approaches. We have modified a new approach for axillary vein catheterization: the oblique-axis/in-plane approach. Read More

Intensive Care Med 2019 06 13;45(6):876-880. Epub 2019 Feb 13.

Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Henri Mondor Hospital, Créteil, France.

J Vasc Access 2019 Nov 31;20(6):763-768. Epub 2019 Jan 31.

Department of Surgery, "A. Gemelli" University Hospital Foundation, Catholic University of the Sacred Heart, Rome, Italy.

Introduction: Ultrasound-guided cannulation of the axillary vein in the infraclavicular area has several potential advantages for both short-term and long-term venous access devices. Currently, there are two techniques to approach axillary vein for ultrasound-guided cannulation: out-of-plane puncture in the short-axis view and the in-plane puncture in the long-axis view. We propose a novel ultrasound-guided puncture technique of axillary vein for centrally inserted central catheter placement, which consists in the oblique-axis view of the axillary vein coupled with the in-plane puncture. Read More