482 results match your criteria Central Venous Access Femoral Vein


Transposition of the superficial femoral artery combined with ultrasound-guided returning-venous cannulation as a last resort for vascular access in a multi-complicated hemodialysis patient.

J Vasc Access 2021 Jun 6:11297298211023288. Epub 2021 Jun 6.

Department of Surgery, Saiwaicho Memorial Hospital, Okayama, Japan.

A superficialized artery as a blood-drawing route could be an option for vascular access (VA) in hemodialysis patients with cardiac failure, vessel damage, steal syndrome, and venous hypertension, and it could be a secondary VA option in those with repetitive vascular access troubles, routinely requiring a blood-returning venous route. The brachial artery is preferably used for superficialization due to the benefit of its appropriate diameter for cannulation, procedural ease of surgery under local anesthesia, and usable subcutaneous vein for blood-returning route in the upper limb. The superficial femoral artery (SFA) has also been reported as a candidate for arterial transposition; however, its subcutaneous transposition could have difficulties in requiring general anesthesia and securing blood-inflow-venous routes. Read More

View Article and Full-Text PDF

Preferential central venous catheter access with concurrent IVC filter use.

J Vasc Access 2021 May 10:11297298211015073. Epub 2021 May 10.

AMITA Health, General Surgery, Chicago, IL, USA.

In our aging population, there is an increased incidence of concurrent IVC filter and central venous catheter use. One of the risks of concurrent use is filter embolization, which almost always occurs due to the J-tipped guidewire. In this case, we describe the successful placement of a central venous catheter in the femoral vein in a patient with an IVC filter. Read More

View Article and Full-Text PDF

Distal superficial femoral vein versus axillary vein central catheter placement under ultrasound guidance for neonates with difficult access: A randomized clinical trial.

J Vasc Access 2021 Apr 28:11297298211011867. 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

View Article and Full-Text PDF

Severe leg swelling following removal of a temporary femoral venous hemodialysis catheter.

Semin Dial 2021 May 25;34(3):263-265. Epub 2021 Apr 25.

University Vascular Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.

Temporary central venous catheters are commonly used for patients who require emergency hemodialysis (HD). An arteriovenous fistula (AVF) is a rare complication of this procedure. In this case report, we present a patient who was diagnosed with an iatrogenic femoral AVF after cannulation of the right femoral vein with a temporary HD catheter. Read More

View Article and Full-Text PDF

An unexpected diagnosis of intravascular loss of guidewire after central venous catheterization - a case report.

Pol Merkur Lekarski 2021 Apr;49(290):143-145

Medical University of Gdansk, Poland: Department of Internal and Pediatric Nursery.

Hemodialysis is the dominant method of renal replacement therapy. The condition of its effectiveness is obtaining adequate vascular access, among others, central catheters. Central venous catheterization is a routine procedure, but it carries a risk of complications. Read More

View Article and Full-Text PDF

Ultrasound-guided cannulation of the superficial femoral vein for central venous access.

J Vasc Access 2021 Mar 21:11297298211003745. Epub 2021 Mar 21.

Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.

Background: In some clinical conditions, central venous access is preferably or necessarily achieved by threading the catheter into the inferior vena cava. This can be obtained not only by puncture of the common femoral vein at the groin, but also-as suggested by few recent studies-by puncture of the superficial femoral vein at mid-thigh.

Methods: We have retrospectively reviewed our experience with central catheters inserted by ultrasound-guided puncture and cannulation of the superficial femoral vein, focusing mainly on indications, technique of venipuncture, and incidence of immediate/early complications. Read More

View Article and Full-Text PDF

Ionizing radiation exposure from dialysis tunneled catheters procedures: European directive and legal implications.

J Vasc Access 2021 Mar 14:11297298211001141. Epub 2021 Mar 14.

Nephrology and Dialysis Department, "Maggiore della Carità" University Hospital, Novara, Italy.

Background: Advances in medical imaging and interventional procedures have been associated with increased exposure to ionizing radiation. Thus, the International Commission on Radiological Protection (ICRP) established uniform safety standards to protect the general public against the dangers arising from ionizing radiations. In Europe, the ICRP standards are listed in the European Directive 2013/59/EURATOM, which should be transposed into national legislation by member states. Read More

View Article and Full-Text PDF

Detachment and embolization of totally implantable central venous access devices: diagnosis and management.

Acta Chir Belg 2021 Mar 9:1-8. Epub 2021 Mar 9.

Department of Oncology, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.

Background: Detachment and embolization (DE) is a rare complication of totally implantable central venous access devices (TIVADs). This study aimed to analyze clinical findings, etiology, and treatment options in DE of TIVADs.

Methods: Patients who experienced DE between 2010-2019 were included. Read More

View Article and Full-Text PDF

Inferior vena cava surgical cannulation for infants needing veno-venous extracorporeal membrane oxygenation.

Perfusion 2021 Jan 7:267659120987089. Epub 2021 Jan 7.

Department of Anesthesia and Intensive Care, IRCCS-ISMETT, Palermo, Italy.

Introduction: Femoral cannulation for veno-venous extracorporeal membrane oxygenation is challenging in infants because of the diameter of the vein.

Case Report: Prolonged ECMO support (67 days) was necessary for an 8-month-old (8 kg) girl with acute respiratory distress syndrome that was caused by H1N1 influenza. After 30 days on ECMO support and using a single 16 Fr double-lumen cannula (internal jugular vein), a second cannula was necessary to ensure adequate flow. Read More

View Article and Full-Text PDF
January 2021

Novel Reconstruction of Complex Central Venous Occlusion Using Supraclavicular Stent Graft in Hemodialysis Patients.

Ann Vasc Surg 2021 May 26;73:185-196. Epub 2020 Dec 26.

DFW Vascular Group, Dallas, TX; Surgery, Methodist Dallas Medical Center, Dallas, TX; TCU School of Medicine, Ft. Worth, TX. Electronic address:

Background: Subclavian vein and brachiocephalic vein occlusions are challenging problems in dialysis patients with ipsilateral upper extremity (UE) vascular access or in need of one. HeRO grafts (Hemodialysis Reliable Outflow, Merit Medical Systems, Inc, South Jordan, UT) have been used to manage such occlusions but patients with chronic hypotension treated with HeRO graft may have threatened patency. We describe an alternative technique using a supraclavicular stent graft to reconstruct the venous outflow, evaluate outcomes of this procedure, and discuss its role in complex hemodialysis patients. Read More

View Article and Full-Text PDF

Long-term outcomes of transposed femoral vein arteriovenous fistula for abandoned upper extremity dialysis access.

J Vasc Surg 2021 Mar 2. Epub 2021 Mar 2.

Division of Vascular Diseases and Surgery, Department of Surgery, Ohio State University School of Medicine, Columbus, Ohio.

Background: The number and longevity of patients with end-stage renal disease requiring dialysis access have continued to increase, leading to challenging situations, including exhausted upper extremity access and severe central venous stenosis. This has led to an increase in the use of alternative access sites, including the lower extremities. The transposed femoral vein arteriovenous fistula for dialysis access is a previously described alternative, although limited data are available on its long-term patency. Read More

View Article and Full-Text PDF

Risk Factors for Central Venous Access Device-Related Thrombosis in Hospitalized Children: A Systematic Review and Meta-Analysis.

Thromb Haemost 2021 May 13;121(5):625-640. Epub 2020 Nov 13.

Xiangya Nursing School, Central South University, Changsha, China.

Objective:  To identify the potential associations of patient-, treatment-, and central venous access device (CVAD)-related factors with the CVAD-related thrombosis (CRT) risk in hospitalized children.

Methods:  A systematic search of PubMed, EMBASE, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, Wanfang, and VIP database was conducted. RevMan 5. Read More

View Article and Full-Text PDF

A retrospective analysis of the clinical effectiveness of subcutaneously tunneled femoral vein cannulations at the bedside: A low risk central venous access approach in the neonatal intensive care unit.

J Vasc Access 2020 Nov 5:1129729820969291. Epub 2020 Nov 5.

St. Joseph's Children's Hospital, Paterson, NJ, USA.

Objective: The purpose of this retrospective analysis was to evaluate the clinical efficacy and safety of ultrasound (US)-guided, subcutaneously tunneled, femoral inserted central catheters (ST-FICCs) in the neonatal intensive care unit (NICU).

Methods: Following clinical success with ST-FICCs in adults, we expanded this practice to the neonatal population. In an 18-month retrospective cohort analysis (2018-2020) of 82 neonates, we evaluated the clinical outcome for procedural success, completion of therapy, and incidence of early and late complications for insertion of US-guided ST-FICCs in the NICU. Read More

View Article and Full-Text PDF
November 2020

Rapid Femoral Vein Assessment (RaFeVA): A systematic protocol for ultrasound evaluation of the veins of the lower limb, so to optimize the insertion of femorally inserted central catheters.

J Vasc Access 2020 Oct 16:1129729820965063. Epub 2020 Oct 16.

Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Rome, Italy.

In this paper we describe a new protocol-named RaFeVA (Rapid Femoral Vein Assessment)-for the systematic US assessment of the veins in the inguinal area and at mid-thigh, designed to evaluate patency and caliber of the common and superficial femoral veins and choose the best venipuncture site before insertion of a FICC. Read More

View Article and Full-Text PDF
October 2020

Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit.

Ann Intensive Care 2020 Sep 7;10(1):118. Epub 2020 Sep 7.

Surgical and Medical Intensive Care Unit Hôpital, Raymond Poincaré, 9230, Garches, France.

The French Society of Intensive Care Medicine (SRLF), jointly with the French-Speaking Group of Paediatric Emergency Rooms and Intensive Care Units (GFRUP) and the French-Speaking Association of Paediatric Surgical Intensivists (ADARPEF), worked out guidelines for the management of central venous catheters (CVC), arterial catheters and dialysis catheters in intensive care unit. For adult patients: Using GRADE methodology, 36 recommendations for an improved catheter management were produced by the 22 experts. Recommendations regarding catheter-related infections' prevention included the preferential use of subclavian central vein (GRADE 1), a one-step skin disinfection(GRADE 1) using 2% chlorhexidine (CHG)-alcohol (GRADE 1), and the implementation of a quality of care improvement program. Read More

View Article and Full-Text PDF
September 2020

Ultrasound-guided double central venous access for azygos vein via the ninth and tenth intercostal veins.

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

View Article and Full-Text PDF

How I Do It: Ultrasound-Guided Internal Jugular and Femoral Central Venous Catheter Insertion.

Chest 2020 12 26;158(6):2425-2430. Epub 2020 Jun 26.

Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY.

Central venous catheterization is routinely performed in the ICU to obtain venous access for hemodynamic monitoring, parenteral nutritional support, hemodialysis, and delivery of fluids and vasoactive medications. Although central venous catheters can be lifesaving, their insertion is not without risk. Historically, central veins were accessed using landmark-based techniques, but the medical literature strongly supports the use of ultrasound guidance. Read More

View Article and Full-Text PDF
December 2020

Bowel Puncture During Insertion of a Femoral Central Line in the Emergency Department.

Am J Case Rep 2020 Jun 16;21:e924607. Epub 2020 Jun 16.

Department of Critical Care, Dalhousie University, Halifax, Nova Scotia, Canada.

BACKGROUND Central venous catheter (CVC) insertion is commonly performed in the emergency department. The femoral vein is often chosen for insertion of CVCs due to its lower risk for complication. We present a rare complication of bowel puncture during insertion of a femoral CVC in the emergency department in a 46-year-old female. Read More

View Article and Full-Text PDF

Single-access ultrasound-guided tunneled femoral lines in critically ill pediatric patients.

J Vasc Access 2020 Nov 15;21(6):1034-1041. Epub 2020 Jun 15.

Division of Interventional Radiology, Seattle Children's Hospital and University of Washington, Seattle, WA, USA.

Central venous access is an essential aspect of critical care for pediatric patients. In the critically ill pediatric population, image-guided procedures performed at the bedside expedite care and may reduce risks and logistical challenges associated with patient transport to a remote procedure suite such as interventional radiology. We describe our institutional technique for ultrasound-guided tunneled femoral venous access in neonates and infants and provide technical pearls from our experience, with an intended audience including specialists performing point-of-care ultrasound-guided procedures as well as interventional radiologist making their services available in the intensive care unit. Read More

View Article and Full-Text PDF
November 2020

Safety and feasibility of unilateral double femoral venous access including double sheath insertion via a single-hole method for adrenal venous sampling.

Jpn J Radiol 2020 Aug 13;38(8):800-806. Epub 2020 Apr 13.

Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University Hospital, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

Purpose: To assess the safety and feasibility of unilateral double femoral venous access including double sheath insertion via a single-hole method (two-in-one method) for adrenal venous sampling (AVS).

Materials And Methods: Two 5-Fr sheaths were percutaneously inserted into a single femoral vein for AVS in 324 patients. Two needles were inserted sequentially in tandem under ultrasound guidance; furthermore, two sheaths were individually inserted (two-in-two method) if both punctures were successfully achieved. Read More

View Article and Full-Text PDF

Determination of optimal implantation site in central venous system for wireless hemodynamic monitoring.

Int J Cardiol Heart Vasc 2020 Apr 3;27:100510. Epub 2020 Apr 3.

Cardiovascular Research & Innovation Centre, National University of Ireland Galway, Ireland.

Background/purpose: In recent years, treatment of heart failure patients has proved to benefit from implantation of pressure sensors in the pulmonary artery. Despite this, pulmonary artery pressure is related to the left ventricle, and cannot provide information on the right side of the heart. By contrast, pressure in the central venous system is directly connected to the right atrium and could potentially predict a wider range of heart failure conditions. Read More

View Article and Full-Text PDF

European Society of Anaesthesiology guidelines on peri-operative use of ultrasound-guided for vascular access (PERSEUS vascular access).

Eur J Anaesthesiol 2020 05;37(5):344-376

From the Anesthesiology Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE (ML), Intensive Care Unit, Department of Emergency, Intensive Care Medicine and Anesthesiology, Fondazione Policlinico Universitario 'A. Gemelli' IRCCS, Rome, Italy (DGB), Department of Anaesthesiology, IRCCS Istituto Giannina Gaslini, Genova (ND), Department of Surgery, Fondazione Policlinico Universitario 'A. Gemelli' IRCCS, Rome, Italy (MP), Department of Anesthesia, Klinikum Klagenfurt, Klagenfurt, Austria (CB), Anaesthesia and Intensive Care Unit, Melegnano Hospital (DV), Department of Surgical and Intensive Care Unit, Sesto San Giovanni Civic Hospital, Milan, Italy (MS), Department of Anesthesiology, Lithuanian University of Health Sciences, Kaunas, Lithuania (VT, AM), Department of Anaesthesiology, Intensive Care, and Pain Medicine, University hospital of Rennes, Rennes (JPE), Institut Universitaire du Cancer Toulouse Oncopole, Department of Anaesthesiology, Toulouse (RF), Department of Anaesthesiology, Pierre Oudot hospital, Bourgoin-Jallieu, France (EB), Leeds Institute of Medical Research at St James's School of Medicine, University of Leeds, Leeds, UK (PH).

: Ultrasound for diagnostic and procedural purposes is becoming a standard in daily clinical practice including anaesthesiology and peri-operative medicine. The project of European Society of Anaesthesiology (ESA) Task Force for the development of clinical guidelines on the PERioperative uSE of Ultra-Sound (PERSEUS) project has focused on the use of ultrasound in two areas that account for the majority of procedures performed routinely in the operating room: vascular access and regional anaesthesia. Given the extensive literature available in these two areas, this paper will focus on the use of ultrasound-guidance for vascular access. Read More

View Article and Full-Text PDF

Cannulation of the superficial femoral vein at mid-thigh when catheterization of the superior vena cava system is contraindicated.

J Vasc Access 2020 Jul 25;21(4):524-528. Epub 2019 Dec 25.

Department of IV team, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Purpose: Patients needing medium- to long-term infusion therapy with limited catheterization via the superior vena cava system is a challenging condition. The conventional catheterization via the femoral vein in the groin has a high complication rate, discomfort, and short indwelling time. Since changing the insertion site can avoid the disadvantage of conventional catheterization via the femoral vein in the groin, the present study aimed to investigate the effects of femoral inserted central catheters insertion via the superficial femoral vein at the mid-thigh to resolve the issue of limited superior vena cava system catheterization. Read More

View Article and Full-Text PDF

Simultaneous placement of leadless pacemaker and dialysis catheter in patient with exhausted vasculature.

J Vasc Access 2021 Jan 23;22(1):147-150. Epub 2019 Dec 23.

Medical University in Poznan, Poznan, Poland.

The problem with limited venous access may occur in patients receiving long-term hemodialysis treatment with no possibility of arteriovenous access or in patients with cardiac implantable electronic device-related infection leading to the removal of cardiac implantable electronic device. We present a case report where both situations occur simultaneously. Using recent development in cardiac pacing-leadless cardiac pacemaker-we manage to overcome the vascular access problem. Read More

View Article and Full-Text PDF
January 2021

A Novel Inside-out Access Approach for Hemodialysis Catheter Placement in Patients With Thoracic Central Venous Occlusion.

Am J Kidney Dis 2020 04 29;75(4):480-487. Epub 2019 Nov 29.

Department of Nephrology, Medical University of Vienna, Vienna, Austria.

Rationale & Objective: Left-sided internal jugular and all subclavian central venous catheters (CVCs) cause thoracic central vein occlusions (TCVOs) more often than right-sided internal jugular catheters. To enable right-sided CVC placement in patients with TCVO, an inside-out access (IOA) approach was established at 3 vascular access centers in Europe involving use of a novel IOA device advanced from the right femoral vein. In the current analysis, we assessed the eligibility and success rate of this IOA approach in a cohort of patients with TCVO requiring a tunneled dialysis catheter. Read More

View Article and Full-Text PDF

Reduced patency in left-sided arteriovenous grafts in a porcine model.

J Vasc Surg 2020 07 4;72(1):305-317.e6. Epub 2019 Nov 4.

Division of Vascular and Endovascular Surgery, Department of Surgery, Yale University, New Haven, Conn; Vascular Biology and Therapeutics Program, Yale University School of Medicine, New Haven, Conn; Department of Surgery, VA Connecticut Healthcare Systems, West Haven, Conn. Electronic address:

Objective: The porcine arteriovenous graft model is commonly used to study hemodialysis vascular access failure, with most studies using a bilateral, paired-site approach in either the neck or femoral vessels. In humans, left- and right-sided central veins have different anatomy and diameters, and left-sided central vein catheters have worse outcomes. We assessed the effect of laterality on arteriovenous prosthetic graft patency and hypothesized that left-sided carotid-jugular arteriovenous prosthetic grafts have reduced patency in the porcine model. Read More

View Article and Full-Text PDF

Atrial Fibrillation and Atrial Flutter Ablation - an Unconventional Approach.

J Atr Fibrillation 2019 Jun 30;12(1):2106. Epub 2019 Jun 30.

Medical Student Government Kilpauk Medical College & Hospital.

Background: Radiofrequency cathether ablation (RFCA) of Atrial Fibrillation (AFib) and typical atrial flutter (AF) is traditionally performed via femoral vein approach and all devices are designed to be delivered via inferior access. In rare cases of congenital or iatrogenic obstruction of inferior vena cava (IVC), RFCA of arrhythmias is performed via transhepatic approach.

Case Report: 87 year old male patient with history of IVC filter placement for recurrent deep venous thrombosis and AFib on amiodarone developed symptoms with worsening Afib burden resulting in deterioration of left ventricular ejection fraction. Read More

View Article and Full-Text PDF

Landmark versus ultrasound-guided insertion of femoral venous catheters in the pediatric intensive care unit: An efficacy and safety comparison study.

Med Intensiva (Engl Ed) 2020 Mar 17;44(2):96-100. Epub 2019 Oct 17.

Graduate School of Universidad de Chile, Pediatric Intensive Care, Specialization Program, Santiago, Chile.

Background: Central venous cannulation (CVC) is common and necessary in pediatric intensive care. However, this procedure is not without risks or complications. Although CVCs have classically been placed following anatomical landmarks, the use of ultrasound guidance has largely replaced the latter, given its better profile of efficacy and safety, demonstrated at least in adult populations. Read More

View Article and Full-Text PDF

Recommendations on the Use of Ultrasound Guidance for Central and Peripheral Vascular Access in Adults: A Position Statement of the Society of Hospital Medicine.

J Hosp Med 2019 Sep 6;14:E1-E22. Epub 2019 Sep 6.

Division of General & Hospital Medicine, University of Texas Health San Antonio, San Antonio, Texas.

Preprocedure: 1) We recommend that providers should be familiar with the operation of their specific ultrasound machine prior to initiation of a vascular access procedure.2) We recommend that providers should use a high-frequency linear transducer with a sterile sheath and sterile gel to perform vascular access procedures.3) We recommend that providers should use two-dimensional ultrasound to evaluate for anatomical variations and absence of vascular thrombosis during preprocedural site selection. Read More

View Article and Full-Text PDF
September 2019