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    166 results match your criteria Central Venous Access Subclavian Vein Subclavian Approach

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    A comparison of longitudinal and transverse approaches to ultrasound-guided axillary vein cannulation by experienced operators.
    J Thorac Dis 2017 Apr;9(4):1133-1139
    Department of Intensive Care Unit, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
    Background: The axillary vein is an easily accessible vessel that can be used for ultrasound-guided central vascular access and offers an alternative to the internal jugular and subclavian veins. The objective of this study was to identify which transducer orientation, longitudinal or transverse, is better for imaging the axillary vein with ultrasound.

    Methods: We analyzed 236 patients who had undergone central venous cannulation of axillary vein in this retrospective study. Read More

    Complications after implantation of subcutaneous central venous ports (PowerPort(Ⓡ)).
    Ann Med Surg (Lond) 2017 May 10;17:1-6. Epub 2017 Mar 10.
    Department of Surgery, Kitasato University School of Medicine, Japan.
    Background: The aim of our study was revised as follows: to clarify the postoperative complications of multifunctional central venous ports and the risk factors for such complications to promote the safe use of the PowerPort system in the hospital.

    Methods: The study group comprised 132 patients in whom implantable central venous access ports (PowerPort(Ⓡ)) were placed in our hospital from March 2014 through December 2015. The approach used for port placement was the subclavian vein in 43 patients (33%), the internal jugular vein in 87 patients (66%), and the femoral vein in 2 patients (1%). Read More

    Ultrasound-Guided Subclavian Vein Cannulation in Low Birth Weight Neonates.
    Pediatr Crit Care Med 2017 Feb;18(2):172-175
    1Pediatric and Neonatal Intensive Care Unit, Paris South University Hospitals, Assistance Publique Hôpitaux de Paris, Le Kremlin-Bicêtre, Paris, France. 2School of Medicine, Paris South University, Le Kremlin-Bicêtre, Paris, France. 3Institute of Integrative Biology of the Cell-UMR 9198, Paris Saclay University, Gif-sur-Yvette, Paris, France. 4Espace Ethique/IDF, Saint Louis University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.
    Objectives: Central venous access in critically ill, small infants remains technically challenging even in experienced hands. Several vascular accesses exist, but the subclavian vein is often preferred for central venous catheter insertion in infants where abdominal malformation and/or closure of the vein preclude the use of umbilical venous catheters, as catheterization of the subclavian vein is easier in very short necks than the internal jugular vein for age-related anatomical reasons. The subclavian vein approach is yet relatively undescribed in low birth weight infants (i. Read More

    Analysis of the Outcomes in Central Venous Access Port Implantation Performed by Residents via the Internal Jugular Vein and Subclavian Vein.
    J Surg Educ 2017 May - Jun;74(3):443-449. Epub 2016 Dec 5.
    Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
    Objective: The central venous access port (CVAP) has played an important role in the safe administration of chemotherapy and parenteral nutrition. The aim of the present study was to clarify the optimal access vein for CVAP implantation when performed by residents rather than attending surgeons.

    Methods: A consecutive cases of CVAP implantation via the subclavian vein (SV) using a landmark-guided technique or via the internal jugular vein (JV) using an ultrasound-guided technique were divided into 2 groups according to whether the intervention was performed by a resident or an attending surgeon. Read More

    Infraclavicular access to the axillary vein - new possibilities for the catheterization of the central veins in the intensive care unit.
    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

    A novel "shrug technique" for totally implantable venous access devices via the external jugular vein: A consecutive series of 254 patients.
    J Surg Oncol 2017 Mar 4;115(3):291-295. Epub 2016 Nov 4.
    Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
    Background: The external jugular vein (EJV) approach for totally implantable venous access devices (TIVADs) is safe. However, the success rate is unsatisfactory because of the difficulty in catheterization due to the acute angle between the EJV and the subclavian vein (SCV). A novel "shrug technique" to overcome this difficulty was developed, and its efficacy was assessed in a consecutive case series. Read More

    A Novel Technique of Subclavian Artery Cannulation for Venoarterial Extracorporeal Membrane Oxygenation.
    Exp Clin Transplant 2016 Oct 14. Epub 2016 Oct 14.
    From the Department of Cardiovascular Surgery, Turkey Yuksek Ihtisas Hospital, Ankara, Turkey.
    Objectives: The common femoral artery is the standard site for immediate vascular access when initiating adult venoarterial extracorporeal membrane oxygenation. However, this approach is fraught with problems such as femoral artery occlusion, distal limb ischemia, reperfusion injury resulting in compartment syndrome, retroperitoneal hemorrhage, thrombosis, embolization, and most importantly, pulmonary edema. Here, we show our preference of using the subclavian artery with a side graft as a different cannulation technique for outflow of extracorporeal membrane oxygenation, which can avoid complications associated with different access techniques. Read More

    Novel experience of laser-assisted 'inside-out' central venous access in a patient with bilateral subclavian vein occlusion requiring pacemaker implantation.
    Europace 2016 Oct 14. Epub 2016 Oct 14.
    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

    Application and comparison of different implanted ports in malignant tumor patients.
    World J Surg Oncol 2016 Sep 23;14(1):251. Epub 2016 Sep 23.
    Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510655, China.
    Background: The current study aims to compare the application and convenience of the upper arm port with the other two methods of implanted ports in the jugular vein and the subclavian vein in patients with gastrointestinal cancers.

    Methods: Currently, the standard of practice is placement of central venous access via an internal jugular vein approach. Perioperative time, postoperative complications, and postoperative comfort level in patients receiving an implanted venous port in the upper arm were retrospectively compared to those in the jugular vein and the subclavian vein from April 2013 to November 2014. Read More

    Totally implantable venous access port via the femoral vein in a femoral port position with CT-venography.
    J Surg Oncol 2016 Dec 22;114(8):1024-1028. Epub 2016 Sep 22.
    Department of Surgery, Asahikawa Medical University, Asahikawa City, Japan.
    Background And Purpose: We aimed to determine the success rate and any complications using a percutaneous approach to the femoral vein (FV) for placement of a totally implantable access port (TIVAP), with a preoperative assessment of the femoral and iliac veins using computed tomography-venography (CT-V).

    Methods: A prospective study of 72 patients was conducted where placement of a TIVAP was attempted via the right FV, with the port placed in the anterior thigh, when subclavian vein or jugular vein access was contraindicated. Preoperative assessment of the femoral venous plexus was performed with CT-V in 72 patients. Read More

    12th WINFOCUS world congress on ultrasound in emergency and critical care.
    Crit Ultrasound J 2016 Sep;8(Suppl 1):12
    Anaesthesiology Department, University Science of Malaysia, Kota Bharu, Malaysia.
    Table Of Contents: A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization. A novel approach in emergency departmentMargarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA5 Clinical ultrasound in a septic and jaundice patient in the emergency departmentMargarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA6 Characterization of the eyes in preoperative cataract Saudi patients by using medical diagnostic ultrasoundMustafa Z. Read More

    A Randomized Controlled Comparison of the Internal Jugular Vein and the Subclavian Vein as Access Sites for Central Venous Catheterization in Pediatric Cardiac Surgery.
    Pediatr Crit Care Med 2016 Sep;17(9):e413-9
    1Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey. 2Department of Cardiovascular Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
    Objectives: To compare internal jugular vein and subclavian vein access for central venous catheterization in terms of success rate and complications.

    Design: A 1:1 randomized controlled trial.

    Setting: Baskent University Medical Center. Read More

    Ultrasound-guided central venous access: which probe is preferred for viewing the subclavian vein using a supraclavicular approach?
    Am J Emerg Med 2016 Sep 7;34(9):1761-4. Epub 2016 Jun 7.
    Department of Emergency Medicine, University of California Irvine, Irvine, California.
    Background: Point-of-care ultrasound guidance using a linear probe is well established as a tool to increase safety when performing a supradiaphragmatic cannulation of the internal jugular central vein. However, little data exist on which probe is best for performing a supradiaphragmatic cannulation of the subclavian vein.

    Methods: This was a prospective, observational study at a single-site emergency department, where 5 different physician sonologists evaluate individual practice preference for visualization of the subclavian vein using a supraclavicular approach with 2 different linear probes and 1 endocavitary probe. Read More

    Trapezius placement of implanted ports: understanding the procedure.
    Br J Nurs 2016 Jan;25 Suppl 2:S9-S15
    Procedure Team Manager, The Christie NHS Foundation Trust, Manchester.
    Totally implantable vascular access devices (TIVADs) are indicated for intermittent long-term intravenous access. It is widely accepted within medical literature that TIVADs are associated with statistically significant lower infection rates than other central venous access devices. Typical sites for implantation are on the anterior chest wall, using the internal jugular, axillary, cephalic or a subclavian vein. Read More

    Trapezius placement of implanted ports: understanding the procedure.
    Br J Nurs 2016 Jan 28-Feb 10;25(2):S9-15
    Totally implantable vascular access devices (TIVADs) are indicated for intermittent long-term intravenous access. It is widely accepted within medical literature that TIVADs are associated with statistically significant lower infection rates than other central venous access devices. Typical sites for implantation are on the anterior chest wall, using the internal jugular, axillary, cephalic or a subclavian vein. Read More

    Ultrasound-guided supraclavicular central venous catheter tip positioning via the right subclavian vein using a microconvex probe.
    J Vasc Access 2016 Sep 22;17(5):435-9. Epub 2016 Mar 22.
    Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn - Germany.
    Purpose: The ultrasound-guided central venous catheter (CVC) guidewire tip positioning has been demonstrated for catheterization of the right internal jugular vein. We explored the feasibility of an ultrasound-guided right subclavian vein (RScV) CVC tip positioning via a right supraclavicular approach using a microconvex probe.

    Methods: Twenty patients scheduled for elective surgery were consecutively included in this observational feasibility study following written informed consent. Read More

    Wireless Ultrasound-Guided Axillary Vein Cannulation for the Implantation of Cardiovascular Implantable Electric Devices.
    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

    [Reconstructive operations in pathology of central veins, associated with vascular approach].
    Angiol Sosud Khir 2015 ;21(4):171-7
    Kazan State Medical University, Kazan, Russia.
    Presented herein are the results of treatment of 28 patients with stenosis/occlusion of central veins undergoing replacement therapy by means of programmed haemodialysis for terminal renal failure. The clinical symptomatology in all patients manifested itself by chronic lymphovenous insufficiency of the upper limb, dysfunction of the vascular access (14 patients, thrombosis of the vascular approach (5 patients), venous hypertension of the brain (4 patients). 17 patients had aneurysms of the vascular approach in the zone of puncture. Read More

    Malpositioning of central venous cannula inserted through internal jugular vein after failed cannulation through ipsilateral subclavian vein.
    Anesth Essays Res 2015 May-Aug;9(2):254-6
    Department of Anaesthesiology and Critical Care, Era's Lucknow Medical College, Lucknow, Uttar Pradesh, India.
    The anesthesiologist is frequently involved in the task of achieving central venous access either for intraoperative uses or postoperative purposes or Intensive Care Unit care. We are usually aware of the common complications of subclavian approach, such as arterial puncture, bleeding, pneumothorax, misplacement in the ipsilateral internal jugular vein (IJV) or contralateral brachiocephalic or subclavian vein. In this case report, we highlight the possibility of malpositioning of central venous cannula inserted through IJV into the anterior extra pleural plane after failed subclavian cannulation attempts. Read More

    Implantation of venous access devices under local anesthesia: patients' satisfaction with oral lorazepam.
    Patient Prefer Adherence 2015 7;9:943-9. Epub 2015 Jul 7.
    Department of Radiology, University Hospital of Cologne, Cologne, Germany.
    Objective: The aim of the study reported here was to evaluate patients' satisfaction with implantation of venous access devices under local anesthesia (LA) with and without additional oral sedation.

    Materials And Methods: A total of 77 patients were enrolled in the prospective descriptive study over a period of 6 months. Subcutaneous implantable venous access devices through the subclavian vein were routinely implanted under LA. Read More

    Evaluation of three different techniques for insertion of totally implantable venous access device: A randomized clinical trial.
    J Surg Oncol 2015 Jul 14;112(1):56-9. Epub 2015 Jul 14.
    Department of General Surgery of Hospital de Cl, í, nicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
    Background: Although totally implantable venous access devices (TIVAD) are increasingly being used in oncology patients, more robust evidence about the best technique is lacking, especially regarding to ultrasound (US) guided puncture.

    Methods: One hundred ten patients with indication of intravenous chemotherapy were randomly assigned to TIVAD implant through US-guided internal jugular vein (USG) puncture (39) or internal jugular vein blindly (IJB) (36) or subclavian vein blindly (SCB) (35). Procedure data and complications were prospectively recorded within 30 days of the procedure. Read More

    Dynamic multiplanar real time ultrasound guided infraclavicular subclavian vein catheterization.
    Am Surg 2015 Jun;81(6):621-5
    Virginia Tech-Carilion School of Medicine, Roanoke VA, USA.
    Ultrasound guided vascular access has been well-characterized as a safe and effective technique for internal jugular and femoral vein catheterization. However, there is limited experience with the use of ultrasound to access the infraclavicular subclavian vein. Multiple ultrasound techniques do exist to identify the subclavian vein, but real time access is limited by vessel identification in a single planar view. Read More

    Brachiocephalic Vein Stenting and Body-Floss Technique as a Treatment of CVD in Dialysis-Dependent Patient - Case Report and Literature Review.
    Pol J Radiol 2015 10;80:247-51. Epub 2015 May 10.
    Lower Silesian Centre for Diagnostic Imaging, Hospital to the Wrocław Centre for Research and Development, Wrocław, Poland.
    Background: Given the increasing number of elderly hemodialysis-dependent patients with concomitant chronic diseases the successful creation and maintenance of reliable vascular access become a real challenge. In current literature central vein disease (CVD) is defined as at least 50% narrowing up to total occlusion of central veins of the thorax including superior vena cava (SVC), brachiocephalic (BCV), subclavian (SCV) and internal jugular vein (IJV). The incidence of CVD has been reported to be as high as 23% in the total dialysis population and 41% in those with access related complains. Read More

    Innominate vein repair after iatrogenic perforation with central venous catheter via mini-sternotomy-Case report.
    Int J Surg Case Rep 2015 18;11:98-100. Epub 2015 Mar 18.
    Department of Surgery, University of Arizona Medical Center, University of Arizona, 1501 N Campbell Ave., Tucson, AZ 85719, United States.
    Introduction: Iatrogenic damage of the innominate vein is a possible complication with extracorporeal central venous line catheter insertion techniques. When perforation occurs, the catheter is left in place and surgery is required for careful removal and repair of other possible complications, including hemothorax and cardiac tamponade. The traditional approach for innominate vein repair is via a complete median sternotomy. Read More

    Current use of ultrasound for central vascular access in children and infants in the Nordic countries--a cross-sectional study.
    J Vasc Access 2015 Mar-Apr;16(2):148-51. Epub 2015 Jan 17.
    1 Department of Anaesthesiology, Innlandet Hospital Trust - Elverum, Elverum - Norway.
    Purpose: The use of ultrasound (US) guidance for central vascular access in children has been advocated as a safer approach compared to traditional landmark techniques. We therefore collected data on the current use of US for central vascular access in children and infants in the Nordic countries.

    Methods: A cross-sectional survey using an online questionnaire was distributed to one anaesthesiologist at every hospital in the Nordic countries; a total of 177 anaesthesiologists were contacted from July till August 2012. Read More

    Pneumothorax is a rare complication of thoracic central venous catheterization in community EDs.
    Am J Emerg Med 2015 Jan 18;33(1):60-6. Epub 2014 Oct 18.
    The Permanente Medical Group, Oakland, CA; Department of Emergency Medicine, Kaiser Permanente Oakland Medical Center, Oakland, CA.
    Study Objectives: The rate of iatrogenic pneumothorax associated with thoracic central venous catheterization in community emergency departments (EDs) is poorly described, although such information is vital to inform the procedure's risk/benefit analysis. We undertook this multicenter study to estimate the incidence of immediate catheter-related pneumothorax in community EDs and to determine associations with site of access, failed access, and positive pressure ventilation.

    Methods: This was a secondary analysis of 2 retrospective cohort studies of adults who underwent attempted thoracic central venous catheterization in 1 of 21 EDs. Read More

    Comparison of heparin to citrate as a catheter locking solution for non-tunneled central venous hemodialysis catheters in patients requiring renal replacement therapy for acute renal failure (VERROU-REA study): study protocol for a randomized controlled trial.
    Trials 2014 Nov 19;15:449. Epub 2014 Nov 19.
    Medical Intensive Care Unit, University Hospital of Dijon, 14 rue Paul Gaffarel, 21079 Dijon, France.
    Background: The incidence of acute kidney injury (AKI) is estimated at 10 to 20% in patients admitted to intensive care units (ICU) and often requires renal replacement therapy (RRT). ICU mortality in AKI patients can exceed 50%. Venous catheters are the preferred vascular access method for AKI patients requiring RRT, but carry a risk of catheter thrombosis or infection. Read More

    [Clinical application of totally implantable central venous port].
    Zhonghua Wai Ke Za Zhi 2014 Aug;52(8):608-11
    Department of Breast Center, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China. Email:
    Objective: To summarize the disposal methods and the reasons of complications in operation of totally implantable central venous port (TICVP).

    Methods: A total of 2 007 patients were enrolled in this observational, single-center study between December 2008 and March 2013. TICVP implantation was performed with one small skin incision and subcutaneous puncture of subclavian or jugular vein. Read More

    1000 Port-A-Cath ® placements by subclavian vein approach: single surgeon experience.
    World J Surg 2015 Feb;39(2):328-34
    Department of Academic Surgery, The Royal Marsden NHS Trust, Fulham Road, London, SW3 6JJ, UK.
    Introduction: Totally implantable venous access ports are widely used for the administration of chemotherapy in patients with cancer. Although there are several approaches to implantation, here we describe Port-A-Cath(®) (PAC) placement by percutaneous puncture of the subclavian vein with ultrasonographic guidance.

    Patients And Methods: Data on our vascular access service were collected prospectively from June 2004. Read More

    External jugular vein approach for TIVAD implantation: first choice or only an alternative? A review of the literature.
    J Vasc Access 2015 Jan-Feb;16(1):1-4. Epub 2014 Sep 2.
    Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome - Italy.
    Purpose: Totally implantable venous access devices (TIVADs) can be implanted by percutaneous approach (to the subclavian or internal jugular vein) or by surgical approach, through cephalic vein or external jugular vein (EJV). The authors present a review of the literature about EJV approach for TIVAD implantation.

    Methods: A review of articles indexed in MEDLINE (PubMed) and Cochrane Central Register on "EJV access," "EJV cut-down," and "TIVADs" was performed, even matching the terms. Read More

    A wire transposition technique for recanalization of chronic complex central venous occlusions.
    Phlebology 2016 Feb 1;31(1):57-60. Epub 2014 Sep 1.
    Department of Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg/Saar, Germany.
    Purpose: A minimal-invasive interventional technique for recanalization of complex chronic central venous total occlusions is described to overcome difficulties in case of failure of common approaches.

    Method: We present a patient with a central venous occlusion that caused severe venous congestion of her upper extremity and significant impairment of her forearm hemodialysis shunt. Since the usual transbrachial and transfemoral attempts for recanalization of occluded right subclavian, brachiocephalic, superior vena cava, and proximal internal jugular veins (IJV) failed, the approach was changed to a transjugular access. Read More

    Femoral approach: an exceptional alternative for permanent pacemaker implantation.
    Rev Port Cardiol 2014 May 12;33(5):311.e1-5. Epub 2014 Jun 12.
    Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
    The classic transvenous implantation of a permanent pacemaker in a pectoral location may be precluded by obstruction of venous access through the superior vena cava or recent infection at the implant site. When these barriers to the procedure are bilateral and there are also contraindications or technical difficulties to performing a thoracotomy for an epicardial approach, the femoral vein, although rarely used, can be a viable alternative. We describe the case of a patient with occlusion of both subclavian veins and a high risk for mini-thoracotomy or videothoracoscopy, who underwent implantation of a permanent single-chamber pacemaker via the right femoral vein. Read More

    Clinical guidelines on central venous catheterisation. Swedish Society of Anaesthesiology and Intensive Care Medicine.
    Acta Anaesthesiol Scand 2014 May 5;58(5):508-24. Epub 2014 Mar 5.
    Department of Surgical Sciences, Anaesthesiology and Intensive Care Medicine, University Hospital, Uppsala University, Uppsala, Sweden.
    Safe and reliable venous access is mandatory in modern health care, but central venous catheters (CVCs) are associated with significant morbidity and mortality, This paper describes current Swedish guidelines for clinical management of CVCs The guidelines supply updated recommendations that may be useful in other countries as well. Literature retrieval in the Cochrane and Pubmed databases, of papers written in English or Swedish and pertaining to CVC management, was done by members of a task force of the Swedish Society of Anaesthesiology and Intensive Care Medicine. Consensus meetings were held throughout the review process to allow all parts of the guidelines to be embraced by all contributors. Read More

    Is ultrasound-guided central venous port placement effective to avoid pinch-off syndrome?
    J Vasc Access 2014 Jul-Aug;15(4):311-6. Epub 2014 Jan 27.
    1 Department of Radiology, Iwate Medical University School of Medicine, Morioka - Japan.
    Purpose: Ultrasound (US)-guided internal jugular vein access has been the standard practice of central venous port (CVP) placement. The subclavian vein (SCV) access has also been preferred, but has potential risk of pinch-off syndrome (POS). The purpose of this study was to examine the effect of US-guided SCV access to avoid POS in patients with CVP. Read More

    Central venous access via external jugular vein with CT-venography using a multidetector helical 16-section CT.
    J Invest Surg 2014 Jun 19;27(3):176-82. Epub 2013 Dec 19.
    1Department of Surgery, Pippu Clinic, Pippu, Town Kamikawa-Gun , Hokkaido , Japan.
    Objective: To determine the success rate and complications of using the external jugular vein (EJV) for central venous access with a preoperative estimate of the detailed anatomical orientation of the cervical venous plexus using computed tomography venography (CT-V).

    Design: Prospective, observational human study.

    Setting: Surgical intensive care unit. Read More

    Computed tomography (CT) venography using a multidetector CT prior to the percutaneous external jugular vein approach for an implantable venous-access port.
    Ann Surg Oncol 2014 Apr 4;21(4):1391-7. Epub 2013 Dec 4.
    Department of Surgery, Pippu Clinic, Kamikawa-gun, Hokkaido, Japan,
    Background And Purpose: The objective of this study was to determine the success rate and complications of using the percutaneous approach of the external jugular vein (EJV) for placement of a totally implantable venous-access port (TIVAP) with a preoperative estimate of the detailed anatomical orientation of the cervical venous plexus using computed tomography venography (CT-V).

    Methods: A prospective cohort study of 45 patients in whom placement of a TIVAP was attempted via the right EJV was conducted. The preoperative anatomical estimation of the cervical venous plexus was performed with CT-V using a Multidetector Helical 16-section CT. Read More

    Systematic review and meta-analysis of percutaneous subclavian vein puncture versus surgical venous cutdown for the insertion of a totally implantable venous access device.
    Br J Surg 2014 Jan 26;101(2):8-16. Epub 2013 Nov 26.
    Division of Visceral Surgery, Department of Surgery, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 4, Switzerland.
    Background: Totally implantable venous access devices (TIVADs) are commonly used in patients with cancer. Although several methods of implantation have been described, there is not enough evidence to support the use of a specific technique on a daily basis. The objective of this study was systematically to assess the literature comparing percutaneous subclavian vein puncture with surgical venous cutdown. Read More

    Right heart catheterization using antecubital venous access: feasibility, safety and adoption rate in a tertiary center.
    Catheter Cardiovasc Interv 2014 Jul 9;84(1):70-4. Epub 2013 Nov 9.
    Lahey Clinic, 41 Burlington Mall Road, 5 East, Cardiovascular Medicine, Burlington, Massachusetts.
    Objectives: To determine feasibility, safety, and adoption rates of right heart catheterization (RHC) using antecubital venous access (AVA) as compared to using the traditional approach of proximal venous access (PVA).

    Background: RHC via PVA (i.e. Read More

    Jugular versus femoral short-term catheterization and risk of infection in intensive care unit patients. Causal analysis of two randomized trials.
    Am J Respir Crit Care Med 2013 Nov;188(10):1232-9
    1 Grenoble 1 (Joseph Fourier) University, U823 "Outcome of Cancers and Critical Illness," Albert Bonniot Institute, La Tronche, France.
    Rationale: When subclavian access is not possible, controversy exists between the internal jugular and femoral sites for the choice of central-venous access in intensive care unit patients.

    Objectives: To compare infection and colonization rates of short-term jugular and femoral catheters.

    Methods: Using data from two multicenter studies, we compared femoral and internal jugular for the risks of catheter-related bloodstream infection, major catheter-related infection, and catheter-tip colonization. Read More

    Retained central venous lines (CVLs) after attempted removal: an 11-year series and literature review.
    J Pediatr Surg 2013 Sep;48(9):1887-91
    Department of Paediatric Surgery, Alder Hey Children's Hospital, Liverpool L12 2AP, United Kingdom. Electronic address:
    Background: Central venous lines (CVLs) are frequently used in the management of many neonatal and pediatric conditions. Failure to remove the luminal part of the line (retained CVL) is rare. Consequently, there is lack of experience and consensus in its optimal management. Read More

    [Catheter fracture and pulmonary embolization of the distal fragment: a rare complication of the totally implantable venous access port].
    Rev Med Interne 2015 Jan 17;36(1):42-6. Epub 2013 Sep 17.
    Service d'anesthésie-réanimation, hôpital Mère-Enfant, CHU Mohammed VI, avenue Ibn Sina, Ammerchich 40000, Marrakech, Maroc.
    Introduction: Totally implantable venous access port plays a crucial role in the treatment of patients in oncology. However, its use can result sporadically in catheter fracture with catheter tip embolization into pulmonary arteries.

    Case Reports: We report this unusual but potentially serious complication in four patients. Read More

    Ultrasound-guided subclavian venous catheterisation - is this the way forward? A narrative review.
    Int J Clin Pract 2013 Aug;67(8):726-32
    Imperial School of Anaesthesia, The Hillingdon Hospitals NHS Foundation Trust, London, UK.
    Central venous catheterisation is a commonly performed procedure in anaesthesia, critical care, acute and emergency medicine. Traditionally, subclavian venous catheterisation has been performed using the landmark technique and because of the complications associated with this technique, it is not commonly performed in the United Kingdom - where the accepted practice is ultrasound-guided internal jugular vein catheterisation. Subclavian vein catheterisation offers particular advantages over the internal jugular and femoral vein sites such as reduced rates of line-related sepsis, improved patient comfort and swifter access in trauma situations where the internal jugular vein may not be easily accessible. Read More

    Supraclavicular approach of central venous catheter insertion in critical patients in emergency settings: Re-visited.
    Indian J Crit Care Med 2013 Jan;17(1):10-5
    Department of Anesthesia and Intensive Care, St. Stephen's Hospital, Tis Hazari, New Delhi, India.
    The supraclavicular approach was first put into clinical practice in 1965 by Yoffa and is an underused method for gaining central access. It offers several advantages over the conventional infraclavicular approach to the subclavian vein. At the insertion site, the subclavian vein is closer to the skin, and the right-sided approach offers a straighter path into the subclavian vein. Read More

    Cervical extravasation of bevacizumab.
    Anticancer Drugs 2013 Apr;24(4):426-8
    Departments of Gastroenterology, Cochin Teaching Hospital, AP-HP, Sorbonne Paris Cité, Paris Descartes University, Paris, France.
    Monoclonal antibodies such as bevacizumab are widely used in medical oncology, either alone or in combination with chemotherapy. No specific recommendations on the management of monoclonal antibodies extravasation exist. Incidence rates vary considerably. Read More

    A comparison of longitudinal and transverse approaches to ultrasound-guided axillary vein cannulation.
    Am J Emerg Med 2013 Mar 22;31(3):478-81. Epub 2012 Nov 22.
    Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
    Objective: The axillary vein is an easily accessible vessel that can be used for ultrasound-guided central vascular access and offers an alternative to the internal jugular and subclavian veins. The objective of this study was to identify which transducer orientation, longitudinal or transverse, is better for imaging the axillary vein with ultrasound.

    Methods: Emergency medicine physicians at an inner-city academic medical center were asked to cannulate the axillary vein in a torso phantom model. Read More

    Subclavian central venous catheters and ultrasound guidance: policy vs practice.
    J Vasc Access 2013 Apr-Jun;14(2):104-10. Epub 2012 Nov 21.
    Department of Emergency Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania 19102, USA.
    Purpose: Policy statements recommend the use of ultrasound guidance (USG) to improve patient safety during placement of central venous catheters (CVCs). Studies have conclusively demonstrated greater success rates and fewer complications with the use of USG in catheter placement using the internal jugular vein approach. Data supporting the use of USG for the subclavian vein (SCV) approach, however, have been less conclusive, and USG for SCV cannulation is rarely used in clinical practice. Read More

    Ultrasound guided supraclavicular central vein cannulation in adults: a technical report.
    J Vasc Access 2013 Jan-Mar;14(1):89-93. Epub 2012 Jul 23.
    School of Anesthesia and Intensive Care Medicine, University of Pisa, Pisa, Italy.
    Purpose: Ultrasound-guided (USG) central vein cannulation has become very popular among anesthesiologists and critical care physicians in the last decade and it has been advocated as the gold standard practice for internal jugular vein (IJV) catheterization.

    Methods: We report a technique used at our second level hospital for cannulating either subclavian vein or innominate vein using a supraclavicular (SCV) approach under real time ultrasound guidance for elective positioning of long, medium or short-term central venous catheters (CVC). We report one year of practice. Read More

    Endovascular recanalization of central venous access to allow for pacemaker implantation or upgrade.
    Cardiovasc Revasc Med 2012 Jul-Aug;13(4):215-8
    Washington Hospital Centeriding, 110 Irving Street, NW Suite 4B-1, Washington, DC 20010, USA.
    Background: Several patients undergoing permanent pacemaker (PPM) implantation/upgrade present with difficult access due to sub- or total central vein occlusion. Our institution has used the endovascular approach to recanalize central veins to allow for subsequent PPM implantation. Here we aim to describe the feasibility and safety of using this approach to allow for PPM implantation/upgrade. Read More

    Right- and left-subclavian vein port-a-cath systems: comparison of complications.
    Eur Surg Res 2012 17;49(2):66-72. Epub 2012 Jul 17.
    Department of Surgery, St. Martin De Porres Hospital, Chiayi, Taiwan, ROC.
    Background: Central venous access systems are frequently used for delivery of medications; however, few studies have compared surgical and postoperative complications of right versus left access via the subclavian vein (SCV). The aim of this study was to compare the surgical and postoperative complications associated with Port-A-Cath system insertion via the right and left SCV.

    Methods: The medical records of patients who received Port-A-Cath insertion via the SCV for parenteral chemotherapy between August 2004 and July 2008 were reviewed. Read More

    Procedural complications of central venous catheter insertion.
    Minerva Anestesiol 2012 Nov 14;78(11):1234-40. Epub 2012 Jun 14.
    Department of Intensive Care, Sir Charles Gairdner Hospital, Perth, WA, Australia.
    Background: Central venous catheters (CVC) have complication rates as high as 20% and are associated with significant morbidity and mortality. In this study we wished to determine the incidence of procedural related complications at different venous access sites as well as the impact of ultrasound (US) use, operator experience and level of supervision of trainees in a prospective observational study.

    Methods: Five hundred consecutive patients undergoing elective CVC insertion were prospectively followed. Read More

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