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central vein access

Mariusz Kusztal, Krzysztof Nowak
For arrhythmia treatment or sudden cardiac death prevention in hemodialysis patients, there is a frequent need for placement of a cardiac implantable electronic device (pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization device). Leads from a cardiac implantable electronic device can cause central vein stenosis and carry the risk of tricuspid regurgitation or contribute to infective endocarditis. In patients with end-stage kidney disease requiring vascular access and cardiac implantable electronic device, the best strategy is to create an arteriovenous fistula on the contralateral upper limb for a cardiac implantable electronic device and avoidance of central vein catheter...
March 1, 2018: Journal of Vascular Access
Afsha Aurshina, Anil Hingorani, Ahmad Alsheekh, Pavel Kibrik, Natalie Marks, Enrico Ascher
OBJECTIVE: It has been a widely accepted practice that a previous placed pacemaker, automatic implantable cardioverter defibrillators, or central line can be a contraindication to placing a hemodialysis catheter in the ipsilateral jugular vein. Fear of dislodging pacing wires, tunneling close to the battery site or causing venous obstruction has been a concern for surgeons and interventionalists alike. We suggest that this phobia may be unfounded. METHODS: A retrospective review was conducted of patients in whom hemodialysis catheters were placed over a period of 10 years...
March 1, 2018: Journal of Vascular Access
Peter Paik, Sanjay K Arukala, Anupam A Sule
Central venous catheters are placed in approximately five million patients annually in the US. The preferred site of insertion is one with fewer risks and easier access. Although the right internal jugular vein is preferred, on occasion, the left internal jugular may have to be accessed. A patient was admitted for septic shock, cerebrovascular accident, and non-ST-segment elevation myocardial infarction. A central venous line was needed for antibiotic and vasopressor administration. Due to trauma from a fall to the right side and previously failed catheterization attempts at the left subclavian and femoral veins, the left internal jugular vein was accessed...
January 9, 2018: Curēus
Maurizio Pacilli, Catherine J Bradshaw, Simon A Clarke
INTRODUCTION: Medium-term intravenous access in children is normally achieved by means of repeated multiple peripheral intravenous cannula insertions or peripherally inserted central catheters. Long peripheral cannulas might offer an alternative to these devices in children. Our aim was to clarify whether long peripheral cannulas provide reliable medium-term intravenous access avoiding the need for multiple peripheral intravenous cannulations or peripherally inserted central catheter insertion in children undergoing surgery...
March 1, 2018: Journal of Vascular Access
Anton A Kasatkin, Aleksandr L Urakov, Anna R Nigmatullina
INTRODUCTION: Central venous cannulation may be difficult in morbidly obese patients. We present a case of successful right internal jugular vein catheterization under real-time ultrasound guidance in an obese patient in a forced semi-sitting position. CASE REPORT: A 43-year-old male patient with body mass of 182 kg (body mass index, 52.2 kg/m2 ) was admitted to the clinic 48 h after the trauma. The patient was in a forced semi-sitting position (37° head elevation)...
March 1, 2018: Journal of Vascular Access
Kamran Mohiuddin, David C Bosanquet, Nafi Dilaver, Anthony Davies, Christopher G Davies
BACKGROUND: Significant stenoses in arteriovenous fistulae or grafts (AVFs or AVGs) with limitation of flow and dialysis inadequacy should prompt consideration for fistuloplasty. We sought to identify fistulae, lesions and patient specific variables which predict for outcomes after fistuloplasty. METHOD: ology: Data were extracted retrospectively from renal access database from 2011 to 2016 of patients undergoing fistuloplasty. Demographics, co-morbidities, outcome of intervention and flow rate documented on pre and post intervention duplex were collected...
March 6, 2018: Annals of Vascular Surgery
Bart L Dolmatch, John C Gurley, Kevin M Baskin, Boris Nikolic, Jeffrey H Lawson, Surendra Shenoy, Theodore F Saad, Ingemar Davidson, Mark O Baerlocher, Emil I Cohen, Sean R Dariushnia, Salomão Faintuch, Bertrand Janne d'Othee, Thomas B Kinney, Mehran Midia, James Clifton
No abstract text is available yet for this article.
March 1, 2018: Journal of Vascular and Interventional Radiology: JVIR
Tushar J Vachharajani, Anil K Agarwal, Arif Asif
Exhausted vasculature is not uncommon in patients receiving long-term hemodialysis treatment. Certain patients exhaust their peripheral veins and do not retain the venous capital necessary for fistula creation. Others suffer from severe peripheral arterial disease and despite the presence of adequate venous capital are not able to receive an arteriovenous access successfully. Most importantly, in the case of occluded central veins, the creation of an arteriovenous access in the arms or thighs would be futile, even if peripheral veins and/or arteries were available...
February 21, 2018: Kidney International
Sagar Rambhia, Matthew Janko, Robert I Hacker
Central venous occlusion is conventionally managed with balloon angioplasty, stent extension or sharp recanalization. Here we describe recanalization of a chronically occluded innominate vein using excimer laser after conventional techniques were unsuccessful. Patient clinical improvement and fistula patency have been sustained two years post-intervention. This technique may provide new hemodialysis access options for patients who would not otherwise be candidates for hemodialysis access on the ipsilateral side of a central venous occlusion...
February 15, 2018: Annals of Vascular Surgery
Jill Adamski
Extracorporeal photopheresis is an immunomodulatory therapy indicated for patients with cutaneous T-cell lymphoma, graft-versus-host disease, and heart or lung allograft rejection. Whole blood from the patient is drawn into the photopheresis instrument where it is separated into its components. Plasma, red blood cells, and the treated buffy coat are subsequently returned to the patient. Consistent, adequate blood flow is necessary to successfully complete the procedure. Vascular access options for photopheresis include peripheral vein cannulation, tunneled central venous catheters, and subcutaneous ports...
February 2018: Transfusion
Stephanie Volpi, Francesco Doenz, Salah D Qanadli
Superior vena cava (SVC) syndrome is a group of clinical signs caused by the obstruction or compression of SVC and characterized by edema of the head, neck, and upper extremities, shortness of breath, and headaches. The syndrome may be caused by benign causes but most of the cases are caused by lung or mediastinal malignant tumors. Stenting of SVC has become widely accepted as the palliative treatment for this condition in malignant diseases, as it offers rapid relief of symptoms and improves the quality of life...
2018: Frontiers in Surgery
J M Fichelle, V Baissas, S Salvi, J N Fabiani
Superior vena cava (SVC) stenosis or thrombosis is a well-known complication of central venous catheterization for endocavitary treatments, hemodialysis, or chemotherapy. In cancer patients, these SVC lesions are often symptomatic due to intimal damage and chemotherapy toxicity. We report our experience with six patients treated between 2007 and 2012 via an endovascular approach (n=5) or a direct surgical approach (n=1). All patients had SVC syndrome with facial edema, headache and upper limb edema. In three cases, the catheter was in place when the clinical symptoms occurred...
February 2018: Journal de Médecine Vasculaire
Alex Chau, Jose Alberto Hernandez, Sheena Pimpalwar, Daniel Ashton, Kamlesh Kukreja
BACKGROUND: Femoral tunneled central line placement in the pediatric population offers an alternative means for intravenous (IV) access, but there is concern for higher complication and infection rates when placed at bedside. OBJECTIVE: To describe the complications and infection outcomes of primary femoral tunneled central venous catheter placement in the interventional radiology suite compared to the portable bedside location at a single tertiary pediatric institution...
February 8, 2018: Pediatric Radiology
Michael Wagner, Monika Olischar, Megan O'Reilly, Katharina Goeral, Angelika Berger, Po-Yin Cheung, Georg M Schmölzer
OBJECTIVE: During neonatal cardiopulmonary resuscitation, early establishment of vascular access is crucial. We aimed to review current evidence regarding different routes for the administration of medications during neonatal resuscitation. DATA SOURCES: We reviewed PubMed, EMBASE, and Google Scholar using MeSH terms "catheterization," "umbilical cord," "delivery room," "catecholamine," "resuscitation," "simulation," "newborn," "infant," "intraosseous," "umbilical vein catheter," "access," "intubation," and "endotracheal...
February 5, 2018: Pediatric Critical Care Medicine
Mick Kumwenda, Lisa Dougherty, Helen Spooner, Victoria Jackson, Sandip Mitra, Nicholas Inston
Tunnelled central venous access devices (CVADs) are defined as any intravenous multipurpose catheters placed within the central veins for use in haemodialysis and administration of blood products or chemotherapy in oncology and haematological conditions. Frequent complications include thrombosis and catheter-related infection, which may lead to significant adverse patient outcomes. Once thrombosis is suspected correction should be attempted empirically with thrombolytic agents. Commonly available thrombolytic agents in the UK include urokinase (Syner-Kinase) and alteplase (Cathflo)...
January 25, 2018: British Journal of Nursing: BJN
Mayra Gonçalves Menegueti, Natália Cristina Betoni, Fernando Bellissimo-Rodrigues, Elen Almeida Romão
INTRODUCTION: Bloodstream infections are the second most common cause of death among patients on hemodialysis. This study aimed to evaluate the incidence of and risk factors associated with central venous catheter-related infections in patients undergoing hemodialysis, and to identify and characterize the type and antimicrobial susceptibility profiles of the primary microorganisms isolated during one year of follow-up. METHODS: A prospective cohort study was conducted in 2014 in a hemodialysis referral center...
November 2017: Revista da Sociedade Brasileira de Medicina Tropical
Elizabeth Spiwak, Chad Wiesenauer, Arun Panigrahi, Ashok Raj
Central vein thrombosis as a cause of chylothorax is uncommon, and in a few cases in the literature was related to thrombotic complications of central venous access devices (CVAD). Superior vena cava (SVC) occlusion-induced chylothorax has been described in adult sickle cell disease (SCD) in a setting of chronic indwelling CVAD. There are limited reports on chylothorax induced by central venous thrombosis secondary to chronic CVAD in children with SCD. We describe an 8-year-old male patient, with a history of SCD, maintained on long term erythrocytapheresis for primary prevention of stroke, and whose clinical course was complicated by chylothorax which was successfully treated with a pleuroperitoneal shunt...
January 2, 2018: Children
Huashe Wang, Yonghe Chen, Aihong Liu, Jun Xiang, Yijia Lin, Yue'e Wen, Xiaobin Wu, Junsheng Peng
OBJECTIVE: To describe and analyze the complications of subcutaneous venous access port for patients with gastrointestinal malignancy. METHODS: Data of 1 912 patients with gastrointestinal malignancy who accepted chemotherapy in our department via subcutaneous venous access ports, including 127 cases in upper arm, 865 cases in subclavicular vein and 920 cases in internal jugular vein, from June 2007 to April 2016 were analyzed retrospectively. Associated complications and risk factors were emphatically investigated...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Martin Jonczyk, Bernhard Gebauer, Roman Rotzinger, Dirk Schnapauff, Bernd Hamm, Federico Collettini
BACKGROUND: Totally implantable central venous port systems provide a safe and effective, long-term means of access for administration of hyperosmolar, local irritant medication, such as chemotherapy, antibiotics and parenteral nutrition. AIM: To evaluate the combination of access site and level of experience on fluoroscopy times (FT) and dose area products (DAP) during implantation of port catheters in a large patient population. MATERIALS AND METHODS: A total of 1,870 patients (992 women, 878 men; age: 61±13...
January 2018: In Vivo
Yen-Hsiang Wang, Chieh-Shou Su, Keng-Hao Chang, Chi-Jen Went, Wen-Lieng Lee, Chih-Hung Lai
The use of central venous port access is increasing due to the requirements of multimodal intravenous therapy.1 However, catheter malposition in smaller veins can lead to vein thrombosis, phlebitis and pain. Herein, we report our experience with the use of percutaneous interventions to correct migrated port catheter malposition. Minimally invasive percutaneous interventional correction of malposition could be an alternative to extraction and re-implantation of malpositioned port catheters.
December 1, 2017: Perfusion
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