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J Card Surg 2018 10 5;33(10):679-681. Epub 2018 Sep 5.

Faculty of Medicine, Department of Cardiovascular Surgery, Inonu University, Malatya, Turkey.

J Vasc Access 2018 Nov 12;19(6):667-671. Epub 2018 Apr 12.

2 School of Nursing, University of Trieste, Trieste, Italy.

Introduction:: A safe, largely used practice for difficult venous access patients is positioning a catheter in deeper veins under ultrasound guide. However, the risk of complications is increased when there is a high catheter-to-vein ratio or when the insertion site is in a zone with particular anatomical/physiological characteristics.

Case Description:: A 60-year-old woman admitted to a post-operative intensive care unit after cardiac surgery had a complicated post-operative course. Read More

J Vasc Access 2018 May 29;19(3):311-315. Epub 2018 Mar 29.

1 Department of Surgery, Tohoku Rosai Hospital, Sendai, Japan.

Purpose: Peripherally inserted central venous catheters are some of the most useful devices for vascular access used globally. Peripherally inserted central venous catheters have a low rate of fatal mechanical complications when compared to non-tunnel central venous catheters. However, as peripherally inserted central venous catheter access requires a smaller vein, there is a high risk of thrombosis. Read More

J Vasc Access 2018 May 27;19(3):297-302. Epub 2018 Mar 27.

3 Department of Surgery, Institute of Oncology, Istanbul University, Istanbul, Turkey.

Aim: To examine whether the real-time ultrasound-guided venipuncture for implantable venous port placement is safer than the traditional venipuncture.

Methods: The study analyzed the results of 2153 venous ports placed consecutively from January 2009 to January 2016. A total of 922 patients in group 1 and 1231 patients in group 2 were admitted with venous port placed using the traditional landmark subclavian approach and real-time ultrasound-guided axillary approach, respectively. Read More

J Vasc Access 2018 Jul 12;19(4):396-397. Epub 2018 Mar 12.

1 Department of Diagnostic Radiology, NHIS Ilsan Hospital, Koyang, Korea.

Introduction: We report a case of vein rupture by Arrow-Trerotola percutaneous thrombolytic device (Trerotola PTD) during a treatment of thrombosed arteriovenous graft (AVG).

Case Description: A 77-year-old woman with a problem of thrombosed AVG underwent an endovascular treatment including a procedure of angioplasty of axillary vein. After angioplasty of axillary vein, we found a newly developed thrombus in axillary vein and performed thrombolysis using an over-the-wire 7F Trerotola PTD. Read More

Emerg Med J 2018 May 9;35(5):297-302. Epub 2018 Mar 9.

Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Introduction: Ultrasound assessment of the inferior vena cava (IVC) has gained favour in aiding fluid management decisions for controlled, mechanically ventilated patients as well as in non-mechanically ventilated, spontaneously breathing patients. Its utility in spontaneously breathing patients during positive pressure non-invasive ventilation has not yet been determined. The use of the axillary vein, as an alternative option to the IVC due to its ease of accessibility and independence from intra-abdominal pressure, has also not been evaluated. Read More

Ther Clin Risk Manag 2018 20;14:331-340. Epub 2018 Feb 20.

Department of Critical Care Medicine, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.

Background: A long-axis in-plane (LA-IP) approach and a short-axis out-of-plane (SA-OOP) approach are the two main approaches used in ultrasound (US)-guided vascular catheterization. However, the efficacy and safety of these approaches remain controversial. Therefore, we performed this meta-analysis to compare the two techniques in vascular catheterization. Read More

Medicine (Baltimore) 2017 Dec;96(50):e9073

Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Seongsan-gu, Changwon.

Rationale: Thrombosis due to anastomotic site stenosis is the most common complication in patients with brachio-axillary arteriovenous graft (AVG). Intravascular stent placement may play a special role in the salvage of dialysis grafts that have been previously performed percutaneous angioplasty or surgical procedure on the graft. Herein, we applied a novel stent named Supera which has a high degree of flexibility and resistance to external compression for treating a patient with recurrent venous anastomotic stenosis of brachio-axillary AVG. Read More

J Vasc Surg 2018 03 16;67(3):860-867. Epub 2017 Nov 16.

Department of Surgery, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Korea.

Objective: The objective of this study was to conduct a prospective clinical trial evaluating the technical feasibility and short-term clinical outcome of the blind pushing technique for placement of pretrimmed peripherally inserted central catheters (PICCs) through brachial vein access.

Methods: Patients requiring PICC placement at any of the three participating institutions were prospectively enrolled between January and December 2016. The review boards of all participating institutions approved this study, and informed consent was obtained from all patients. Read More

J Anaesthesiol Clin Pharmacol 2017 Jul-Sep;33(3):337-341

Department of Anaesthesia, The Queen Elizabeth Hospital, The University of Adelaide, Adelaide, South Australia, Australia.

Background And Aims: Ultrasound (US)-guided infraclavicular approach for axillary vein (AXV) cannulation has gained popularity in the last decade.

Material And Methods: In this manikin study, we evaluated the feasibility of a training model for teaching AXV cannulation. The learning pattern with this technique was assessed among attending anesthesiologists and residents in training. Read More

Sci Transl Med 2017 Nov;9(414)

Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455, USA.

Prosthetic arteriovenous grafts (AVGs) conventionally used for hemodialysis are associated with inferior primary patency rates and increased risk of infection compared with autogenous vein grafts. We tissue-engineered an AVG grown from neonatal human dermal fibroblasts entrapped in bovine fibrin gel that is then decellularized. This graft is both "off-the-shelf" (nonliving) and completely biological. Read More

J Vasc Surg 2017 12 31;66(6):1792-1797. Epub 2017 Aug 31.

Department of Vascular Surgery, Medical School, National and Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.

Background: Arteriovenous grafts made of polyurethane (PU) have the advantage of early cannulation obviating the placement of a central vein catheter in patients with an acute need for long-term hemodialysis. The aim of the present study was to evaluate the safety, efficacy and complication rate of PU vascular grafts for dialysis access in patients in whom early cannulation was performed.

Methods: Between January 2007 and December 2015, 125 straight brachial-axillary grafts were placed in patients with an acute thrombosis of a previous arteriovenous access. Read More

Semin Vasc Surg 2016 Dec 17;29(4):186-191. Epub 2017 May 17.

Vascular Surgery Unit, University of Messina, Messina, Italy.

This clinical report details the results of endovascular treatment of symptomatic superior vena cava syndrome due to central vein stenosis or obstruction (CVSO) by stent angioplasty in patients with dialysis-dependent end-stage renal disease. A 3-year retrospective review of two institutional registries identified 25 chronic hemodialysis patients (17 men, 8 women) affected by CVSO who received endovascular treatment. The majority of the patients (n = 19) presented with symptomatic arm, breast, and facial swelling; and 6 patients presented with dialysis-access dysfunction and venous-line hypertension. Read More

Pediatr Radiol 2017 Nov 1;47(12):1676-1681. Epub 2017 Aug 1.

Division of Neonatology, Department of Pediatrics, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Background: Peripherally inserted central catheters (PICCs) represent a mainstay of intravascular access in the neonatal intensive care setting when long-term vascular access is needed. Ideally, PICCs should be inserted and maintained in a central position with the tip ending in the superior or inferior vena cava. This is not always achievable, and sometimes the tip remains in a peripheral location. Read More

Congenit Heart Dis 2017 Dec 9;12(6):800-807. Epub 2017 Jul 9.

Department of Pediatric Cardiology, Kemerburgaz University School of Medicine, Istanbul, Turkey.

Objectives: To retrospectively review the outcome of stent placement in neonates with a vertical ductus, present a technique of ductal stenting via the axillary artery and compare it to ductal stening via the femoral venous access.

Design: Nineteen patients with duct-dependent pulmonary circulations through a vertical ductus arteriosus were treated with stent implantation. Those patients were retrospectively included in the study. Read More

J Vasc Access 2017 Jul 23;18(4):345-351. Epub 2017 Jun 23.

Department of Pulmonology, Korea University Guro Hospital, Korea University College of Medicine, Seoul - Korea.

Purpose: To evaluate long-term clinical outcomes and complications of the single-incision technique for implantation of totally implantable venous access ports (TIVAPs) via the axillary vein.

Materials And Methods: A total of 932 TIVAPs were placed in 927 patients between May 2012 and October 2014 using a single-incision technique. Patients included 620 men and 307 women with a mean age of 60. Read More

Pediatr Surg Int 2017 Sep 27;33(9):1001-1005. Epub 2017 Jun 27.

Department of Surgery, Medstar Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, DC, 20007, USA.

Purpose: To assess the indications, safety and outcomes of tunneled central venous catheters (CVCs) placed via a cutdown approach into the axillary vein in children, an approach not well described in this population.

Methods: A retrospective cohort study was performed on pediatric patients who received CVCs via open cannulation of the axillary vein or one of its tributaries between January 2006 and October 2016 at two hospitals.

Results: A total of 24 axillary CVCs were placed in 20 patients [10 male (42%); mean weight 7. Read More

Ann Vasc Surg 2017 Nov 21;45:262.e7-262.e10. Epub 2017 Jun 21.

Department of Vascular Surgery, DeBakey Heart and Vascular Institute, Houston Methodist Hospital, Houston, TX. Electronic address:

Patients with prolonged history of central venous catheters can develop central venous occlusion. We report the creation of an axillary artery to right atrial graft using the femoropopliteal vein (FPV) for dialysis access in a patient with end-stage renal disease on hemodialysis with history of central venous occlusion. The patient had previously developed steal syndrome following a right brachial artery to right atrial polytetrafluoroethylene graft requiring revision to a left axillary artery inflow which subsequently thrombosed. Read More

Chest 2017 12 3;152(6):1128-1134. Epub 2017 Jun 3.

University of Alabama at Birmingham, Birmingham, AL.

Background: Prostacyclins improve symptoms and survival in pulmonary arterial hypertension (PAH). In response to risks associated with external delivery systems, an implantable IV infusion system was developed. A multicenter, prospective, single-arm, clinical trial (DelIVery for PAH) was conducted to evaluate this system for treprostinil in PAH. Read More

Cir Pediatr 2016 Oct 10;29(4):149-152. Epub 2016 Oct 10.

Servicio de Cirugía Pediátrica. Hospital Clinico Universitario Virgen de la Arrixaca. Murcia.

Objetives: The implantation of long duration intravenous catheters in pediatric population constitutes a challenge due to the size of vascular structures. Because of that, ultrasound is an important tool for vascular accesses in newborns and infants. The objective is to analyze our experience in ultrasound-guided implantation of reservoir type and tunneled catheters, as well as to compare it between both age groups. Read More

J Cardiothorac Vasc Anesth 2017 Oct 15;31(5):1707-1712. Epub 2017 Feb 15.

Department of Anesthesia, Khoula Hospital, Muscat, Oman.

Objective: The primary objective was to compare the frequency of first-attempt successful axillary vein cannulation by the Seldinger technique using out-of-plane ultrasound guidance versus in-plane imaging. Between the two ultrasound imaging planes, this study also compared the number of attempts that were necessary for the cannulation of the left axillary vein along with the number of needle redirections that had to be done for final cannulation of the vein. Incidence of complications and the number of times the procedure was abandoned also were compared between the two imaging planes. Read More

J Intensive Care Med 2017 Jul 30;32(6):396-399. Epub 2017 Mar 30.

1 Department of Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA.

The Centers for Disease Control and Prevention guidelines for the prevention of catheter-related bloodstream infections suggest using "a subclavian site, rather than an internal jugular or a femoral site, in adult patients." This recommendation is based on evidence of lower rates of thrombosis and catheter-related bloodstream infections in patients with subclavian central venous catheters (CVCs) compared to femoral or internal jugular sites. However, preference toward a subclavian approach to CVC insertion is hindered by increased risk of mechanical complications, especially pneumothorax, when compared to other sites. Read More

Pacing Clin Electrophysiol 2017 Jun 16;40(6):638-643. Epub 2017 May 16.

Department of Cardiology, Hospital Infanta Cristina, Badajoz, Spain.

Background: When permanent pacemaker implantation is not possible or advisable via superior venous access (i.e., axillary or subclavian veins), safe and feasible surgical alternatives are required. Read More

Ann Vasc Surg 2017 Jul 22;42:32-38. Epub 2017 Mar 22.

Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA; The Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA. Electronic address:

Background: Current guidelines recommend vascular mapping ultrasound (US) prior to arteriovenous fistula creation. Blunted venous waveforms (BVWs) suggest central venous stenosis; however, this relationship and one between BVWs and the presence of a central venous catheter (CVC) remain unclear.

Methods: All patients who received upper extremity vascular mapping US between January 2013 and October 2014 at a single institution were retrospectively reviewed. Read More

Europace 2017 Sep;19(9):1514-1520

McGill University Health Centre, 1650 Cedar Avenue, Room E5-200, Montreal, Quebec H3G 1A4, Canada.

Aims: Percutaneous subclavian, axillary, and cephalic vein access are all used in conjunction for atrial and ventricular lead implantation, though no standard approach for cardiac resynchronization therapy (CRT) device implantation has been established. We describe an effective and a safe technique for implanting three leads via cephalic vein for CRT pacemaker and/or defibrillator implantations.

Methods And Results: A total of 171 consecutive patients undergoing de novo implantation of CRT pacemaker or defibrillator were included. Read More

Herzschrittmacherther Elektrophysiol 2017 Mar 9;28(1):67-69. Epub 2017 Feb 9.

Campus Virchow-Klinikum, Medizinische Klinik mit Schwerpunkt Kardiologie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13553, Berlin, Deutschland.

If a transfemoral approach for catheter ablation procedures of paroxysmal supraventricular tachycardias is impossible, other access sites have to be considered. We present the case of a 78-year-old woman with an inferior vena cava (IVC) filter with symptomatic episodes of an atrioventricular nodal reentrant tachycardia (AVNRT). We used a combined cubital and axillary vein approach. Read More

Europace 2017 02;19(2):329-331

Montreal Heart Institute/Université de Montréal, Montreal, QC, Canada.

We report a case in which a novel three-dimensional (3D) electromagnetic cardiovascular navigation system (MediGude™, St. Jude Medical, St. Paul, MN, USA) was used to create a 3D reconstruction of the axillary vein and its anatomic course to guide its successful puncture and cannulation. Read More

J Vasc Access 2017 Jul 14;18(4):e39-e41. Epub 2017 Jul 14.

Vascular Surgery Department, Cleveland Clinic, Cleveland, OH - USA.

Background: Central vein thrombosis or obstruction is a common complication associated with central venous catheters placed for intermittent hemodialysis. The reported outcomes of percutaneous catheter-based interventions reveal high rates of lesion recurrence with varying and frequently limited patency intervals. We present the case of open venous bypass in the treatment of catheter-associated chronic central vein occlusion. Read More

Pan Afr Med J 2016 10;24:305. Epub 2016 Aug 10.

Service Universitaire de Chirurgie Générale, Hôpital Régional de Zaghouan, Faculté de Médecine de Tunis, Tunisie.

Eur J Pediatr 2017 Mar 16;176(3):407-411. Epub 2017 Jan 16.

Department of Paediatrics, Mercy Hospital for Women, 163 Studley Road, Melbourne, VIC, 3084, Australia.

We investigated dwell times and risk of non-elective removal of 975 single-lumen 1-French peripherally inserted central catheters (1FR-PICC) according to tip position in a cohort of very preterm infants with a mean (SD) gestational age of 27 (2) weeks and a mean (SD) birth weight of 988 (294) g over an eight-year period. Infants with a 1FR-PICC inserted for continuous infusion of intravenous fluids within the first 30 days of life were eligible. Dwell times of PICC with elective versus non-elective removal, risk of non-elective removal of PICC according to tip position, and differences between upper versus lower limb catheter insertion were analysed. Read More

Einstein (Sao Paulo) 2016 Oct-Dec;14(4):561-566

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

Vascular punctures are often necessary in critically ill patients. They are secure, but not free of complications. Ultrasonography enhances safety of the procedure by decreasing puncture attempts, complications and costs. Read More

Europace 2017 Dec;19(12):2001-2006

Cardiology Department, Pasteur University Hospital, 30 Avenue De La Voie Romaine, 06000 Nice, France.

Aim: Axillary vein access for pacemaker implantation is uncommon in many centres because of the lack of training in this technique. We assessed whether the introduction of the axillary vein technique was safe and efficient as compared with cephalic vein access, in a centre where no operators had any previous experience in axillary vein puncture.

Methods And Results: Patients undergoing pacemaker implantation were randomized to axillary or cephalic vein access. Read More

Anaesthesiol Intensive Ther 2016 21;48(5):360-366. Epub 2016 Nov 21.

Department of Anesthesiology and Critical Care, PS ZOZ Wojewodzkie Centrum Medyczne w Opolu, Poland.

Central vein cannulation is one of the most commonly performed procedures in intensive care. Traditionally, the jugular and subclavian vein are recommended as the first choice option. Nevertheless, these attempts are not always obtainable for critically ill patients. Read More

Europace 2017 Oct;19(10):1750-1753

Department of Cardiology, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Marton Road, Middlesbrough TS4 3BW, UK.

Aim: This new laser facilitated 'inside-out' technique was used for transvenous pacemaker insertion in a pacemaker-dependent patient with bilateral subclavian occlusion and a failed epicardial system who is not suitable for a transfemoral approach.

Method And Results: Procedure was undertaken under general anaesthesia with venous access obtained from right femoral vein and left axillary vein. 7F multipurpose catheter was used to enter proximal edge of the occluded segment of subclavian vein via femoral approach, which then supported stiff angioplasty wires and microcatheters to tunnel into the body of occlusion. Read More

Europace 2017 Jul;19(7):1193-1197

Alice Ho Miu Ling Nethersole Hospital, Hong Kong, People's Republic of China.

Aims: Existing data on the relationship between venous access and long-term pacemaker lead failure (PLF) are scarce and inconsistent. We aim to study the hypothesis that contrast-guided axillary vein puncture (AP) is better than subclavian puncture (SP) and similar to cephalic vein cutdown (CV) in the incidence of PLF and the success rate of AP is higher than CV.

Methods And Results: The case records of 409 patients with 681 implantable pacemaker leads were reviewed. Read More

Anat Cell Biol 2016 Sep 29;49(3):210-212. Epub 2016 Sep 29.

Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Inida.

Persistence of jugulocephalic vein is one of the extremely rare variations of the cephalic vein. Knowledge of such a variation is of utmost importance to orthopedic surgeons while treating the fractures of the clavicle, head and neck surgeons, during surgery of the lower part of neck, for cardiothoracic surgeons and radiologists during catheterization and cardiac device placement. We report the persistent jugulocephalic vein in an adult male cadaver, observed during the routine dissection classes. Read More

J Artif Organs 2017 Mar 5;20(1):57-61. Epub 2016 Oct 5.

Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco De Quiroga 15, Tlalpan, Sección XVI, 14080, Mexico City, Mexico.

Exhaustion of superficial veins coupled with the presence of intrathoracic central venous occlusions remains a significant obstacle for hemodialysis access creation; complex arteriovenous graft (AVG) configurations have been described. The axillary-iliac AVG was first reported in 1987, and few authors have explored this access. We evaluated our experience with this AVG configuration utilizing the early cannulation (EC) graft Flixene™ (Atrium ™, Hudson, NH, USA). Read More

Anaesthesist 2016 Nov;65(11):866-871

Bodensee Medizin Campus, Klinik für Anästhesie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Röntgenstraße 2, 88048, Friedrichshafen, Deutschland.

Injuries to blood vessels near the heart can quickly become life-threatening and include arterial injuries during central venous puncture, which can lead to hemorrhagic shock. We report 6 patients in whom injury to the subclavian artery and vein led to life-threatening complications. Central venous catheters are associated with a multitude of risks, such as venous thrombosis, air embolism, systemic or local infections, paresthesia, hemothorax, pneumothorax, and cervical hematoma, which are not always immediately discernible. Read More

J Vasc Bras 2016 Oct-Dec;15(4):275-279

Centro Universitário CESMAC, Departamento Anatomia Humana, Maceió, AL, Brazil.

Background: The axillary vein is an important blood vessel that participates in drainage of the upper limb. Some individuals present a second axillary vein (accessory axillary vein), which is an important collateral drainage path.

Objectives: The goal of this study was to determine the incidence of the accessory axillary vein and to describe this vessel's topography. Read More

Anaesth Crit Care Pain Med 2017 Feb 2;36(1):65-68. Epub 2016 Aug 2.

Department of Anaesthesiology, Critical Care, Pain and Emergency Medicine, Nîmes University Hospital, place du Pr-Robert-Debré, 30029 Nîmes cedex 9, France; EA 2992, Nîmes Faculty of Medicine, Montpellier University, avenue Kennedy, 30000 Nîmes, France.

Objective: To compare the area of the lumen of the axillary and subclavian veins using ultrasound (US) in 50 healthy volunteers.

Methods: Using an ultrasound device, depth, area, short axis vein length and long axis vein, vein-artery and vein-pleura distances were measured for axillary and subclavian approaches.

Results: The mean cross-sectional area of the axillary vein was greater than the mean cross-sectional area of the subclavian vein (327±89 mm versus 124±46 mm, P<0. Read More

J Vasc Access 2016 Jul 1;17(4):348-52. Epub 2016 Jun 1.

Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Seoul - Korea.

Purpose: To evaluate effectiveness of breast fixation to reduce migration of the catheter tip of a totally implantable venous access port (TIVP) in women.

Materials And Methods: TIVPs were placed in 129 women via the right axillary vein from July 2012 to December 2014, with a final study population of 118 patients (mean age, 55.3 ± 13. Read More

Med Clin (Barc) 2016 Aug 3;147(3):116-20. Epub 2016 May 3.

Department of Pediatrics, Gastroenterology, and Allergology, Medical University of Bialystok, Bialystok, Polonia.

Central venous catheterization is commonly performed in clinical practice. Traditional procedural technique is based on anatomical landmarks, but is associated with a high risk of failure and complications. To decrease their incidence European and American societies recommend application of ultrasonography. Read More

J Crit Care 2016 06 2;33:32-7. Epub 2016 Mar 2.

Department of Operations Research, Wroclaw University of Technology, Wybrzeze Wyspianskiego 27, 50-370 Wroclaw, Poland.

Purpose: The main purpose of this study was to define the venipuncture and catheterization success rates and early mechanical complication rates of ultrasound-guided infraclavicular axillary vein cannulation.

Materials And Methods: We performed in-plane, real-time, ultrasound-guided infraclavicular axillary vein catheterizations under emergency and nonemergency conditions in mechanically ventilated, critically ill patients.

Results: We performed 202 cannulation attempts. Read More

J Crit Care 2016 06 29;33:38-41. Epub 2015 Dec 29.

Department of Infectious Diseases, "A. Gemelli" Teaching Hospital, Catholic University of the Sacred Heart, Rome, Italy.

Purpose: Placement of central venous catheters by the infraclavicular route can be achieved by ultrasound-guided puncture of the axillary vein. However, in some cases, the axillary vein may be difficult to puncture because it is too deep or too small or because it is collapsing significantly during breathing. The objective of this observational study was to determine the effect of 90° abduction of the arm associated with forward position of the shoulder on axillary vein diameters. Read More

J Vasc Access 2016 May 5;17(3):273-8. Epub 2016 Feb 5.

Department of Operations Research, Wroclaw University of Technology, Wroclaw - Poland.

Purpose: We developed the new technique of the axillary vein catheterization, which is connected with the determination of only two anatomical points of reference for puncture site identification. The primary outcome of this study was to determine the rate of successful catheterizations and the assessment of procedure success rate, depending on cannulation side as well as physician experience. The secondary objective was to evaluate the early complication rate and to determine whether this method can be used in clinical practice. Read More

J Vasc Access 2016 May 5;17(3):249-55. Epub 2015 Feb 5.

Department of Radiology, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang - Korea.

Objective: We investigated which arm and vein led to the most successful outcomes during non-fluoroscopic peripherallyinserted central catheter (PICC) insertion.

Methods: A total of 743 cases from July 2012 to March 2014 were retrospectively reviewed. We also analyzed the following: 1) accessed arm (right or left), 2) accessed vein (cephalic, basilic, or brachial), 3) primary and secondary success rates, 4) causes of failure (location of obstacles), and 5) problemsolving methods for catheter repositioning. Read More

Br J Anaesth 2016 Mar 20;116(3):325-7. Epub 2016 Jan 20.

Anesthesiology Institute, Cleveland Clinic Abu Dhabi, PO box 112412, Abu Dhabi, United Arab Emirates

Br J Anaesth 2016 Feb;116(2):215-22

Critical Care Unit, Department of Anaesthesiology, Critical Care, Pain and Emergency Medicine EA 2992, Faculté de Médecine de Nîmes, Université Montpellier 1, Boulevard Kennedy, Nîmes 30000, France.

Background: Axillary vein catheterization via a distal approach is an alternative to the proximal approach to axillary/subclavian vein catheterization under ultrasound (US) guidance. The aim of this trial was to compare the two approaches.

Methods: In a randomized single-centre study, all patients requiring central vein catheterization in intensive care or the operating room were randomly assigned to proximal or distal approach groups. Read More

J Cardiovasc Electrophysiol 2016 Apr 12;27(4):482-7. Epub 2016 Feb 12.

Cardiology Department, University Hospital Ramon y Cajal, Madrid, Spain.

Introduction: Ultrasound guidance for vascular cannulation seems safer and more effective than an anatomical landmark approach, though it has not gained widespread support partly due to workflow interference of wired probes. A wireless ultrasound transducer (WUST) may overcome this issue. We report the effectiveness, time consumption, and safety of the first-in-human experience in axillary vein cannulation guided with a novel WUST for the implantation of cardiovascular implantable electric devices (CIEDs). Read More

J Am Coll Cardiol 2015 Dec 11;66(22):2475-83. Epub 2015 Oct 11.

Quebec Heart & Lung Institute, Quebec City, Quebec, Canada. Electronic address:

Background: Isolated tricuspid valve surgery is associated with high morbidity and mortality, especially in patients with prior cardiac surgery. The transcatheter Forma Repair System (Edwards Lifesciences, Irvine, California) is designed to provide a surface for native leaflet coaptation to reduce tricuspid regurgitation (TR) by occupying the regurgitant orifice area.

Objectives: This study sought to evaluate the feasibility and exploratory efficacy with this transcatheter repair system for the treatment of severe TR. Read More