Transrenal Hemodialysis Catheter Insertion and Replacement in Patients with Upper Extremity Central Venous Access Exhaustion

2021 ◽  
Author(s):  
Joonho Hur ◽  
Boryeong Jeong ◽  
Ji Hoon Shin ◽  
Jae-Ik Bae ◽  
Sang Hwan Lee ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Central Venous Access ◽  
Venous Access ◽  
Catheter Insertion ◽  
Central Venous ◽  
Hemodialysis Catheter

Placement of Tunnelled Hemodialysis Catheters across Stenotic and Occluded Central Veins

2003 ◽  
Vol 4 (1) ◽  
pp. 3-8 ◽  
Author(s):  
A. Falk ◽  
A. Alomari ◽  
J.E. Silberzweig
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Access ◽  
Catheter Insertion ◽  
Brachiocephalic Vein ◽  
Metallic Stent ◽  
Central Venous ◽  
Hemodialysis Catheter

Purpose The purpose of this study was to evaluate the efficacy of placement of tunneled hemodialysis catheters in patients with occluded or stenotic central veins. Materials and Methods Data were prospectively collected for 26 patients (11 male, 15 female, mean age 52 years) referred for placement of tunneled hemodialysis catheters with central venous stenoses or occlusions. The central venous occlusions or stenoses were recanalized using traditional interventional catheter and guidewire techniques. Results Thirty central venous access procedures were performed of which 28 (93%) procedures resulted in successful tunneled catheter insertion. Twenty-one internal jugular venous (13 right, 8 left) and 7 subclavian venous (3 right, 4 left) catheters were placed. Eighteen stenotic and 10 occluded venous segments were crossed including the brachiocephalic vein (n = 22), subclavian vein (n = 2), and the superior vena cava (4). One patient required insertion of a metallic stent to facilitate passage of the hemodialysis catheter across an occluded brachiocephalic vein. No procedure-related complications occurred. No episodes of upper extremity swelling or superior vena cava syndrome occurred following catheter insertion. Conclusion Insertion of tunneled hemodialysis catheter across occluded or stenotic central veins is technically feasible and safe. The use of occluded or stenotic central veins for catheter access preserves patent central veins for future shunt access.

Upper Extremity Deep Venous Thrombosis in Cancer Patients with Venous Access Devices - Prophylaxis with a Low Molecular Weight Heparin (Fragmin)

1996 ◽  
Vol 75 (02) ◽  
pp. 251-253 ◽  
Author(s):  
Manuel Monreal ◽  
Antoni Alastrue ◽  
Miquel Rull ◽  
Xavier Mira ◽  
Jordi Muxart ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Upper Extremity ◽  
Statistical Significance ◽  
Central Venous Access ◽  
Venous Access ◽  
Bleeding Complications ◽  
Fisher Exact Test ◽  
Central Venous ◽  
True Incidence ◽  
Venous Access Devices

SummaryCentral venous access devices are often essential for the administration of chemotherapy to patients with malignancy, but its use has been associated with a number of complications, mainly thrombosis. The true incidence of upper extremity deep vein thrombosis (DVT) in this setting is difficult to estimate since there are very few studies in which DVT diagnosis was based on objective tests, but its sequelae include septic thrombophlebitis, loss of central venous access and pulmonary embolism.We performed an open, prospective study in which all cancer patients who underwent placement of a long-term Port-a-Cath (Pharmacia Deltec Inc) subclavian venous catheter were randomized to receive or not 2500 IU sc of Fragmin once daily for 90 days. Venography was routinely performed 90 days after catheter insertion, or sooner if DVT symptoms had appeared. Our aims were: 1) to investigate the effectiveness of low doses of Fragmin in preventing catheter-related DVT; and 2) to try to confirm if patients with high platelet counts are at a higher risk to develop subclavian DVT, as previously suggested.On the recommendation of the Ethics Committee, patient recruitment was terminated earlier than planned: DVT developed in 1/16 patients (6%) taking Fragmin and 8/13 patients (62%) without prophylaxis (Relative Risk 6.75; 95% Cl: 1.05-43.58; p = 0.002, Fisher exact test). No bleeding complications had developed. As for prediction of DVT, there was a tendency towards a higher platelet count in those patients who subsequently developed DVT, but differences failed to reach any statistical significance (286 ±145 vs 207 ±81 X 109/1; p = 0.067). According to our experience, Fragmin at the dosage used proved to be both effective and safe in these patients.

Upper Extremity Impedance Plethysmography in Patients with Venous Access Devices

1994 ◽  
Vol 72 (04) ◽  
pp. 540-542 ◽  
Author(s):  
McDonald K Horne ◽  
Donna Jo Mayo ◽  
Richard Alexander ◽  
Elizabeth P Steinhaus ◽  
Richard C Chang ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Upper Extremity ◽  
Central Venous Access ◽  
Venous Access ◽  
Impedance Plethysmography ◽  
Venous Obstruction ◽  
Central Venous ◽  
Venous Outflow ◽  
Complete Obstruction ◽  
Venous Access Devices

SummaryCentral venous access devices (VADs) are often associated with thrombotic obstruction of the axillary-subclavian venous system. To explore the accuracy of impedance plethysmography (IPG) in identifying this complication we performed IPG on 35 adult cancer patients before their VADs were placed and approximately 6 weeks later. At the time of the second IPG the patients also underwent contrast venography of the axillary-subclavian system. The venograms revealed partial venous obstruction in 12 patients (34%) and complete obstruction in two (5.7%). Although the IPG results from venographically normal and abnormal patients overlapped extensively, mean measurements of venous outflow were significantly lower in the patient population with abnormal venograms (P = 0.052 for Vo; P = 0.0036 for Vo/Vc). In our hands, therefore, upper extremity IPG cannot be used to make clinical decisions about individual patients with VADs, but it can distinguish venographically normal and abnormal populations.

scholarly journals Central venous access training simulator that enables dilator or catheter insertion

2016 ◽  
Vol 3 (4) ◽  
pp. 424-425
Author(s):  
Nobuyasu Komasawa ◽  
Ryosuke Mihara ◽  
Toshiaki Minami
Keyword(s):  
Central Venous Access ◽  
Venous Access ◽  
Catheter Insertion ◽  
Training Simulator ◽  
Central Venous

Internal Jugular and Upper Extremity Central Venous Access in Interventional Radiology

2000 ◽  
Vol 174 (2) ◽  
pp. 363-366 ◽  
Author(s):  
James G. Caridi ◽  
Jeffery H. West ◽  
S. William Stavropoulos ◽  
Irvin F. Hawkins
Keyword(s):  
Interventional Radiology ◽  
Upper Extremity ◽  
Central Venous Access ◽  
Venous Access ◽  
Central Venous

UPPER EXTREMITY CENTRAL VENOUS ACCESS: WHICH IMAGING STUDY IS BEST?

2002 ◽  
Vol 30 (Supplement) ◽  
pp. A63
Author(s):  
Clare M Savage ◽  
Edmund E. Kim ◽  
Franklin Wong
Keyword(s):  
Upper Extremity ◽  
Central Venous Access ◽  
Imaging Study ◽  
Venous Access ◽  
Central Venous

Successful Long-Term Central Venous Access

1998 ◽  
Vol 2 (1) ◽  
pp. 38-40
Author(s):  
Franco Tesio ◽  
Hamurabi De Baz ◽  
Giacomo Panarello
Keyword(s):  
Central Venous Access ◽  
Venous Access ◽  
Central Venous
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