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Crit Care 2022 06 8;26(1):169. Epub 2022 Jun 8.

Department of Emergency Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China.

Pediatr Int 2022 Jan;64(1):e15128

Critical Care Medicine, National Center for Child Health and Development, Tokyo, Japan.

Background: It is difficult to determine the insertion length of peripherally inserted central catheters (PICCs) without fluoroscopy. The objectives of this study were to examine the relationship between the length from the anterior axillary point to the level of the carina (L ) and patient's height, and to obtain possible estimation formulas that can be considered for validation in future studies.

Methods: We retrospectively analyzed PICCs from the upper arm in the pediatric intensive care unit (PICU) between May 2017 and September 2018. Read More

Pacing Clin Electrophysiol 2022 Jun 18;45(6):717-725. Epub 2022 May 18.

Cardiology Department, Athens General Hospital "G. Gennimatas", Athens, Greece.

Objectives: Many of the complications arising from cardiac device implantation are associated to the venous access used for lead placement. Previous analyses reported that cephalic vein cutdown (CVC) is safer but less effective than subclavian vein puncture (SVP). However, comparisons between these techniques and axillary vein puncture (AVP) - guided either by ultrasound or fluoroscopy - are lacking. Read More

Comput Math Methods Med 2022 22;2022:8016567. Epub 2022 Apr 22.

Ward 2 of the Head and Neck Neurosurgery Department of Hubei Provincial Cancer Hospital, 430079, China.

Objective: A case-control study was conducted to elucidate the impact of application of nursing intervention based on intelligent grip strength system in patients with tumor peripherally inserted central catheter (PICC) on promoting functional exercise and life quality.

Methods: A total of 100 patients with tumor PICC treated in our hospital from April 2019 to April 2021 were enrolled. The patients were randomly assigned into control group and study group. Read More

BMC Cancer 2022 Mar 5;22(1):248. Epub 2022 Mar 5.

Guangdong Provincial Key Laboratory of Malignant Tumor, Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.

Background: Axillary vein/subclavian vein (AxV/SCV) and Internal jugular vein (IJV) are commonly used for implantable venous access port (IVAP) implantation in breast cancer patients for chemotherapy. Previous research focused on comparison of complications while patient comfort was ignored. This study aims to compare patient comfort, surgery duration and complications of IVAP implantation between IJV and AxV/SCV approaches. Read More

J Vasc Access 2021 Dec 30:11297298211063705. Epub 2021 Dec 30.

Intensive Care Unit, Department of Anesthesiology, Critical Care, Pain and Emergency Medicine, Nîmes University Hospital, Nîmes, France.

Background: Real-time ultrasound (US) guidance facilitates central venous catheterization in intensive care unit (ICU). New magnetic needle-pilot devices could improve efficiency and safety of central venous catheterization. This simulation trial was aimed at comparing venipuncture with a new needle-pilot device to conventional US technique. Read More

Medicine (Baltimore) 2021 Dec;100(49):e28100

Department of Radiology, CHU UCL Namur/Site Godinne, Yvoir, Belgium.

Rationale: Central vein thrombosis is an uncommon cause of chylothorax, usually secondary to central venous catheterization in association with prothrombotic state causes such as malignancies. In the following case, thrombosis was located in the left brachiocephalic vein and caused recurrent chylothorax resistant to the first line of treatment and successfully treated by percutaneous recanalization using a dual approach.

Patient Concerns: A 52-year-old male patient with current follicular lymphoma undergoing treatment and recent history of COVID-19 pulmonary infection was hospitalized for dyspnea. Read More

Cureus 2021 Apr 12;13(4):e14436. Epub 2021 Apr 12.

Vascular Surgery, Kahutta Research Laboratory (KRL) Hospital, Islamabad, PAK.

Introduction: Permanent pacemakers' (PPM) implantation is an integral part of electrophysiology and general cardiology. The implantation technique has evolved a lot since the first implantation. Several innovations have been undertaken to improve the effectiveness, life of the transplant, and patient outcomes. Read More

J Vasc Access 2021 Jul 28;22(4):642-649. Epub 2021 Apr 28.

Department of Anesthesiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, PR China.

Background: Epicutaneo-caval catheters (ECCs) are extensively used in premature and ill neonates. This prospective, randomized, observational study aimed to compare the outcomes of ECC placement in the distal superficial femoral and axillary veins in neonates with difficult ECC access.

Methods: In a neonatal intensive care unit at a tertiary referral center, 60 neonates with difficult ECC access were randomized into two groups with catheters placed using the ultrasound-guided modified dynamic needle tip positioning (MDNTP) technique: distal superficial femoral vein (DSFV) and axillary vein (AV) groups. Read More

J Vasc Access 2022 May 1;23(3):474-476. Epub 2021 Mar 1.

Department of Anesthesiology and Operative Intensive Care Medicine, University Hospital of Bonn, Bonn, Germany.

Central venous catheters (CVC) are widely used in critically ill patients and in those undergoing major surgery. Significant adverse events, such as pneumothorax and hemothorax, can be caused by needle insertion during CVC insertion. CVC misplacement is less often described, yet equally important, as it can lead to deleterious complications. Read More

J Cardiovasc Med (Hagerstown) 2021 04;22(4):237-245

Cardiology Division, Ospedale Provinciale AREA VASTA 3, Macerata, Italy.

The current narrative review provides an update of available knowledge on venous access techniques for cardiac implantable electronic device implantation, with a focus on axillary vein puncture. Lower procedure-related and lead-related complications have been reported with extrathoracic vein puncture techniques compared with intrathoracic accesses. In particular, extrathoracic lead access through the axillary vein seems to be associated with lower complication incidence than subclavian vein puncture and higher success rate than cephalic vein cutdown. Read More

J Vasc Access 2022 May 24;23(3):416-421. Epub 2021 Feb 24.

Department of Cardiology, Health Sciences University, Derince Training and Research Hospital, Kocaeli, Turkey.

Background: Preoperative ultrasound (US) for cephalic cut-down is related to shorter procedure time and higher success rate. This study aimed to assess efficiency of US-guided percutaneous cephalic vein (CV) puncture for placement of cardiac implantable electronic devices (CIEDs).

Methods: Patients undergoing a procedure including both US-guided pectoral nerve block (PECS) and percutaneous CV puncture were retrospectively investigated. Read More

Pacing Clin Electrophysiol 2021 04 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

Anaesthesiol Intensive Ther 2021 ;53(3):274-276

Department of Paediatric Anaesthesiology, University Hospital Bonn, Bonn, Germany.

The infraclavicular approach (subclavian approach) to the central vein is most often selected for implantation of a tunnelled Hickman/Broviac cathe­ter because central venous catheter (CVC) insertion into the upper body is optimal considering patient comfort as well as the risk of infection [1] and intravenous thrombosis [2, 3]. How­ever, the actual puncture site for a real-time ultrasound-guided infraclavicular axillary vein approach is at the level of the axillary vein in a much more lateral location than that for the traditional landmark infraclavicular approach to the subclavian vein. This is because an optimal view of the subclavian vein is difficult to obtain with a real-time ultrasound-guided technique, as the ultrasound beam is restricted by the clavicle [4]; the younger the patient, the greater would be its influence because of the width of the ultrasound probe. Read More

Ann Vasc Surg 2021 Jul 5;74:176-181. Epub 2021 Feb 5.

Division of Vascular and Endovascular Surgery, Department of Surgery, University of Kentucky College of Medicine, Lexington, KY.

Background: During endovascular treatment of pararenal aortic aneurysms (PAA) and thoracoabdominal aortic aneurysms (TAAA), our antegrade vascular access of choice is a lateral axillary exposure (LAE). We directly access the axillary artery with multiple sheaths followed by primary closure of the axillary artery at case completion. The aim of this study is to describe our technique and to report our results with this approach. Read More

J Vasc Access 2022 Jan 21;23(1):98-104. Epub 2020 Dec 21.

Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth Deemed University, Puducherry 607402, India.

Background: Long peripheral catheters are the ideal devices for intermediate venous access (1-4 weeks). However due to non-availability and cost constraints, these lines are not widely adapted in developing countries. In this clinical report we describe a technique of using conventional Central Venous Catheters as Midclavicular midlines for intermediate venous access and present the outcome analysis of such catheters in the last 2 years from our institute. Read More

J Cardiovasc Electrophysiol 2021 02 2;32(2):466-467. Epub 2021 Jan 2.

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Turk Kardiyol Dern Ars 2020 11;48(8):779-783

Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.

Ann Palliat Med 2020 Nov 10;9(6):4323-4331. Epub 2020 Nov 10.

Guangdong Provincial Key Laboratory of Malignant Tumor, Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Background: Internal jugular vein (IJV) and axillary vein/subclavian vein (AxV/SCV) are commonly used for implantable venous access port (IVAP) implantation in breast cancer (BC) patients with chemotherapy. Previous studies focused on complications between these different approaches and ignored patient comfort. In this study, we aim to compare patient comfort between IJV and AxV/SCV approaches, as well as surgery duration and complications. 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

J Invasive Cardiol 2020 Sep;32(9):E233-E237

Ascension Saint Thomas Heart, 1840 Medical Center Pkwy #201, Murfreesboro, TN 37129 USA. or

We present two cases where a right heart catheterization was performed from the anatomical snuffbox through the distal cephalic vein along with a left heart catheterization from the distal radial artery. Read More

Pacing Clin Electrophysiol 2020 12 17;43(12):1515-1520. Epub 2020 Sep 17.

Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust, St. George's, University of London, London, UK.

Background: Small series has shown that cardiac resynchronisation therapy (CRT) can be achieved in a majority of patients using exclusively cephalic venous access. We sought to determine whether this method is suitable for widespread use.

Methods: A group of 19 operators including 11 trainees in three pacing centres attempted to use cephalic access alone for all CRT device implants over a period of 8 years. 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

J Interv Card Electrophysiol 2021 Aug 23;61(2):253-259. Epub 2020 Jun 23.

Electrophysiology Unit, Cardiology Department, ESTAV Toscana Sud Est, Misericordia Hospital, Via Senese 161, 58100, Grosseto, Italy.

Purpose: Ultrasound (US)-guided axillary vein cannulation is effective and safe during cardiac implantable electronic devices (CIEDs). It is a reasonable alternative to other techniques in order to shorten procedural time and decrease perioperative complications. However, in this context, the short-axis (out-of-plane) visualization to guide the vein puncture is the most used technique. Read More

J Vasc Access 2021 May 2;22(3):488-491. Epub 2020 Jun 2.

Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.

Vascular access is necessary for hemodialysis, and in some cases where it is difficult to establish an arteriovenous fistula or arteriovenous graft, a permanent hemodialysis catheter may be used. However, serious catheter-related complications, such as central vein stenosis or thrombosis, can occur. We herein present a case of complete brachiocephalic vein obstruction in a patient with lupus nephritis receiving hemodialysis using a tunneled hemodialysis catheter. 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