A brachiocephalic vein abnormality causing a ‘twisted’ central venous catheter

Background Contrast-enhanced ultrasonography (CEUS) using saline was studied to detect supradiaphragmatic central venous catheter malposition. Commonly used echocardiographic views are apical 4-chamber (A4c) and subcostal views. However, this standard method is not feasible in certain situations. We explored the feasibility of the right ventricle inflow parasternal long axis (RVI-PLAX) echocardiographic view and dextrose 50% (D50%) contrast solution for detecting supradiaphragmatic central venous catheter malposition. Method This pilot study screened 60 patients who underwent ultrasound-guided supradiaphragmatic central venous catheter insertion. We compared the investigators' guidewire's J-tip detection, D50% rapid atrial swirl sign (RASS) findings on the RVI-PLAX view and the central venous catheter tip on chest radiograph. We also compared the mean capillary blood sugar level before and after the 5 ml D50% flush. Results No guidewire J-tips were detected from the RVI-PLAX view. The first and second investigators’ diagnosis of central venous catheter malposition detected on RVI-PLAX CEUS achieved an almost perfect agreement (κ = 1.0 (95% confidence interval (CI): 0.90 to 1.0), p < .0001). The RVI-PLAX CEUS was not able to detect two central venous catheter malpositions (one atrial malposition and one left brachiocephalic vein venous catheter malposition). The capillary blood sugar was significantly elevated (8.96 mmol/L vs. 9.75 mmol/L) after D50% flush ( p < 0.005) with no complications reported within 30 minutes after the D50% flush. Conclusion RVI-PLAX view should not be used for guidewire detection. CEUS using D50% and RVI-PLAX view are potentially useful tools in detecting central venous catheter malposition. Further studies comparing them with conventional methods are needed.

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Stenting of the Superior Vena Cava and Left Brachiocephalic Vein with Preserving the Central Venous Catheter in Situ

Korean Journal of Radiology ◽

10.3348/kjr.2011.12.5.629 ◽

2011 ◽

Vol 12 (5) ◽

pp. 629 ◽

Cited By ~ 4

Author(s):

Peter Isfort ◽

Tobias Penzkofer ◽

Fabian Goerg ◽

Andreas H. Mahnken

Keyword(s):

Central Venous Catheter ◽

Superior Vena Cava ◽

Superior Vena ◽

Vena Cava ◽

Venous Catheter ◽

Brachiocephalic Vein ◽

Central Venous ◽

Left Brachiocephalic Vein

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Central Venous Catheter Placement in the Left Internal Jugular Vein Complicated by Perforation of the Left Brachiocephalic Vein and Massive Hemothorax

A & A Case Reports ◽

10.1213/xaa.0000000000000511 ◽

2017 ◽

Vol 9 (1) ◽

pp. 16-19 ◽

Cited By ~ 7

Author(s):

Lindsay R. Wetzel ◽

Priyesh R. Patel ◽

Nicholas L. Pesa

Keyword(s):

Central Venous Catheter ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Venous Catheter ◽

Brachiocephalic Vein ◽

Left Internal Jugular Vein ◽

Central Venous ◽

Central Venous Catheter Placement ◽

Left Brachiocephalic Vein ◽

Massive Hemothorax

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Ultrasound Identification of the Guidewire in the Brachiocephalic Vein for the Prevention of Inadvertent Arterial Catheterization During Internal Jugular Central Venous Catheter Placement

Anesthesia & Analgesia ◽

10.1213/ane.0000000000001446 ◽

2016 ◽

Vol 123 (4) ◽

pp. 896-900 ◽

Cited By ~ 6

Author(s):

Andrew Bowdle ◽

Srdjan Jelacic ◽

Kei Togashi ◽

Renata Ferreira

Keyword(s):

Central Venous Catheter ◽

Venous Catheter ◽

Catheter Placement ◽

Brachiocephalic Vein ◽

Central Venous ◽

Central Venous Catheter Placement ◽

Arterial Catheterization

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Comparison of central venous catheter in brachiocephalic vein and internal jugular vein for the incidence of complications in patients undergoing radiology

Journal of Family Medicine and Primary Care ◽

10.4103/jfmpc.jfmpc_205_19 ◽

2019 ◽

Vol 8 (10) ◽

pp. 3379

Author(s):

MohammadM Gharibvand ◽

Azim Motamedfar ◽

Asadollah Jalil

Keyword(s):

Central Venous Catheter ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Venous Catheter ◽

Brachiocephalic Vein ◽

Central Venous

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A retrospective analysis of the real-time ultrasound-guided supraclavicular approach for the insertion of a tunneled central venous catheter in pediatric patients

The Journal of Vascular Access ◽

10.1177/11297298211008084 ◽

2021 ◽

pp. 112972982110080

Author(s):

Kazuhiko Nakame ◽

Tatsuru Kaji ◽

Shun Onishi ◽

Masakazu Murakami ◽

Ayaka Nagano ◽

...

Keyword(s):

Postoperative Complications ◽

Central Venous Catheter ◽

Real Time ◽

Pediatric Patients ◽

Venous Catheter ◽

Background Information ◽

Brachiocephalic Vein ◽

Central Venous ◽

Supraclavicular Approach ◽

Venous Catheterization

Purpose: Tunneled central venous catheter (tCVC) placement plays an important role in the management of pediatric patients. We adopted a real-time ultrasound (US)-guided supraclavicular approach to brachiocephalic vein cannulation. We evaluated the outcomes of tCVC placement via a US-guided supraclavicular approach. Methods: A retrospective study was performed for patients who underwent US-guided central venous catheterization of the internal jugular vein (IJV group) and brachiocephalic vein (BCV group) in our institution. The background information and outcomes were reviewed using medical records. Results: We evaluated 85 tCVC placements (IJV group: n = 59, BCV group: n = 26). Postoperative complications were recognized in 19 patients in the IJV group (catheter-related bloodstream infection (CRBSI), n = 14 (1.53 per 1000 catheter days); occlusion, n = 1 (1.7%, 1.09 per 1000 catheter days); accidental removal, n = 3 (5.2%, 0.33 per 1000 catheter days); and other, n = 1 (1.7%, 1.09 per 1000 catheter days)) and five patients in the BCV group (CRBSI, n = 2 (0.33 per 1000 catheter days); catheter damage, n = 1 (3.8%, 1.67 per 1000 catheter days); and accidental removal, n = 2 (7.7%, 0.33 per 1000 catheter days)). In the BCV group, despite that, the incidence of postoperative complications was lower ( p = 0.205) and the period of placement was significantly longer in comparison to the IJV group ( p = 0.024). Conclusion: US-guided placement of tunneled CVC though the BCV results in a low rate of postoperative complications despite longer CVC indwelling times compared to IJV insertion. Our results suggest that BCV insertion of tunneled CVC in children may offer advantages in terms of device performance and patient safety.

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Unknown Partial Anomalous Pulmonary Venous Connection Causing Arterial Blood Gases During Central Venous Catheter Insertion

Journal of Integrative Cardiology Open Access ◽

10.31487/j.jicoa.2020.05.03 ◽

2020 ◽

pp. 1-3

Author(s):

Dirk Bandorski ◽

Ivana Petkovic ◽

Pascal Klingenberger ◽

Samuel Dörr ◽

...

Keyword(s):

Central Venous Catheter ◽

Blood Gases ◽

Venous Catheter ◽

Gas Analysis ◽

Brachiocephalic Vein ◽

Diagnostic Tools ◽

Arterial Blood Gases ◽

Central Venous ◽

Arterial Blood ◽

Anomalous Pulmonary Venous Connection

Partial anomalous pulmonary venous connection (PAPVC) is a rare congenital anomaly. We report about the case with an “arterial blood gas” analysis taken from a newly inserted central venous catheter (CVC). Thoracic computed tomography (CT) verified the catheter in the left internal jugular vein. The contrast was given through the catheter which revealed a partial anomalous venous connection of the left upper pulmonary vein to the left brachiocephalic vein. PAPVC should be taken into consideration in cases of “arterial blood gases” taken from a correctly inserted CVC. Most patients are asymptomatic. Adequate diagnostic tools to detect PAPVC are TEE, CT or MRI.

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