Systemic veins

2019 ◽  
pp. 477-486
Keyword(s):  
Pulmonary Arteries ◽  
Central Venous Line ◽  
Venous System ◽  
Central Venous ◽  
Secondary Importance ◽  
Main Indication ◽  
Contrast Enhanced ◽  
Operative Assessment ◽  
Optimal Visualization

Most contrast-enhanced scanning protocols of the thorax are designed to provide optimal visualization of the lungs, pulmonary arteries, heart, or aorta and its branches. Nevertheless, the systemic venous system is routinely imaged during CT examinations, but is often regarded as of secondary importance to the main indication for the scan. However, there are many clinical situations where the visualization of the systemic veins is of prime interest. These include assessment of SVC obstruction, IVC involvement, potential access routes for central venous line wire placement, and pre-operative assessment.

scholarly journals Coexistence of Chronic Constrictive Pericarditis can make the Echocardiographic Diagnosis of Atrial Septal Defect Challenging

2013 ◽  
Vol 1 (2) ◽  
pp. 66-68
Author(s):  
Randhir Singh Rajput ◽  
Sambhunath Das
Keyword(s):  
Atrial Septal Defect ◽  
Constrictive Pericarditis ◽  
Septal Defect ◽  
Central Venous Line ◽  
Central Venous ◽  
Contrast Enhanced ◽  
Shadowing Effect ◽  
Enhanced Computed Tomography ◽  
Pericardial Calcification ◽  
Contrast Enhanced Computed Tomography

ABSTRACT Missing the diagnosis of atrial septal defect (ASD) increases morbidities to patient and may require second surgery or intervention. Chronic constrictive pericarditis produces thickening and calcification of pericardium. The detection of any intracardiac lesion may be difficult by echocardiography due to the masking or shadowing effect of calcified pericardium. We report a case of 30-year-old male presented with congestive heart failure, dyspnea and abdominal swelling. Transthoracic echocardiography diagnosed constrictive pericarditis with no evidence of ASD. The contrast enhanced computed tomography (CECT) showed extensive diffuse pericardial calcification with a large ASD. In the operating room initial transesophageal echocardiography (TEE) examination was not able to detect any ASD. Agitated saline injected through the central venous line into right atrium showed bubbles in the left atrium under TEE monitoring. Subsequent movement of TEE probe in deeper position detected the ASD. It is recommended that all the views and methods of echocardiography examination may be practiced in difficult moments to avoid missing the presence of ASD. How to cite this article Das S, Rajput RS. Coexistence of Chronic Constrictive Pericarditis can make the Echocardiographic Diagnosis of Atrial Septal Defect Challenging. J Perioper Echocardiogr 2013;1(2):66-68.

Central venous line–related thrombosis in children: association with central venous line location and insertion technique

Blood ◽  
2003 ◽  
Vol 101 (11) ◽  
pp. 4273-4278 ◽  
Author(s):  
Christoph Male ◽  
Peter Chait ◽  
Maureen Andrew ◽  
Kim Hanna ◽  
Jim Julian ◽  
...  
Keyword(s):  
Subclavian Vein ◽  
Jugular Vein ◽  
Lymphoblastic Leukemia ◽  
Central Venous Line ◽  
Venous System ◽  
Percutaneous Technique ◽  
Insertion Technique ◽  
Central Venous ◽  
Study Objective ◽  
Venous Thromboembolic Events

Abstract Venous thromboembolic events (VTEs) in children are associated with central venous lines (CVLs). The study objective was to assess whether CVL location and insertion technique are associated with the incidence of VTE in children. We hypothesized that VTE would be more frequent with (1) CVL location on the left body side, (2) CVL location in the subclavian vein rather than the jugular vein, and (3) CVL insertion by percutaneous technique rather than venous cut-down. This was a prospective, multicenter cohort study in children with acute lymphoblastic leukemia who had a CVL placed in the upper venous system during induction chemotherapy. Characteristics of CVL were documented prospectively. All children had outcome assessment for VTE by objective radiographic tests, including bilateral venography, ultrasound, echocardiography, and cranial magnetic resonance imaging. Among 85 children, 29 (34%) had VTE; 28 VTEs appeared in the upper venous system, and 1 was sinovenous thrombosis. Left-sided CVL (odds ratio [OR], 2.5; 95% confidence interval, 1.0-6.4; P = .048), subclavian CVL (OR, 3.1; 95% CI, 1.2-8.5; P = .025), and percutaneous CVL insertion (OR, 3.5; 95% CI, 1.3-9.2; P = .011) were associated with an increased incidence of VTE. Interaction occurred between CVL vein location and insertion technique. Subclavian vein CVL inserted percutaneously had an increased incidence (54%) of VTE compared with any other combination (P = .07). For CVL in the upper venous system, CVL placement on the right side and in the jugular vein may reduce the risk for CVL-related VTE. If subclavian vein placement is necessary, CVL insertion by venous cut-down appears preferable over percutaneous insertion.

Contrast enhanced ultrasound as a new tool to estimate the performance of midline catheters in the single patient

2021 ◽  
pp. 112972982110346
Author(s):  
Antonio Gidaro ◽  
Francesco Casella ◽  
Francesca Lugli ◽  
Chiara Cogliati ◽  
Maria Calloni ◽  
...  
Keyword(s):  
Contrast Enhanced Ultrasound ◽  
Single Patient ◽  
Central Venous ◽  
X Ray ◽  
Chamber View ◽  
Contrast Enhanced ◽  
Chest X Ray ◽  
Vein Diameter ◽  
Tip Position ◽  
Echocardiographic Images

Background: Contrast enhanced ultrasound (CEUS) through MicroBubbles Time (MBT) (time from infusion of saline with addition of micro-bubbles of air to visualization of first bubbles in right atrium (RA), visualized by subxiphoid or apical echocardiography) is an alternative to Intracavitary ECG and chest X-ray in evaluation of tip location in central venous catheters. Objective: To evaluate feasibility and variability of CEUS in peripheral catheters (Midline-MC) in a cohort of patients and in a subgroup where tip location was also performed through chest X-ray. Secondary outcomes were verifying the correlation between MBT and distance between tip of MC and RA (anthropometric and radiological measures), body mass index (BMI), vein diameter at point of insertion. Methods: Patients with insertion of MC were enrolled in this prospective cohort. After catheter insertion, CEUS was performed recording MBT. Results: One hundred thirty-two MCs were inserted, 45 performed Chest X-ray. MBT wasn’t feasible in 7 (5%) because of low quality echocardiographic images. Subcostal view was available in 114 patients (91.2%), while 11 patients (8.8%) were examined through apical four-chamber view. Mean MBT in the whole population was 2.3 ± 0.8 s. Significant correlation between anthropometric and radiological measures, BMI and MBT was found. 32.8% of MC had a MBT ⩽2 s. Conclusions: CEUS could be useful to estimate tip position. Our study showed how 2 s is not a suitable cutoff to confirm central catheter’s tip.

The retrograde tunnel: a method for the fixation of central venous catheters in the military environment

1991 ◽  
Vol 77 (2) ◽  
pp. 75-77
Author(s):  
R. A. Wheeler ◽  
T. J. W. Spalding ◽  
J. A. Thomas ◽  
G. A. Carss
Keyword(s):  
Central Venous Line ◽  
Central Venous Catheters ◽  
Patient Transfer ◽  
Central Venous ◽  
Medical Facilities ◽  
Subcutaneous Tunnel ◽  
Paediatric Practice ◽  
The Military

AbstractCentral venous catheters (CVCs) are prone to accidental removal during patient transportation. Of the casualties who require transfer between medical facilities, those with CVC in situ require additional vigilance to prevent loss of the CVC, which continues to occur despite various methods of fixation. The fashioning of a subcutaneous tunnel has become an integral part of the placement of central venous catheters. Several methods have been described, but the long-term CVCs in paediatric practice pose special problems, particularly that of the patients continually testing the CVCs fixation. Using a new polyurethane CVC, a retrograde tunnelling technique has been developed which affords immediate and secure fixation. We propose that this CVC, together with the technique of retrograde tunnelling, is the solution to inadvertent central venous line removal during patient transfer.

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