Minimally Invasive Repair of Azygos Catheter Migration

2018 ◽  
Author(s):  
Mikin V. Patel ◽  
Steven Zangan
Keyword(s):  
Minimally Invasive ◽  
Surgical Intervention ◽  
Azygos Vein ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Catheter Migration ◽  
Catheter Malfunction ◽  
Catheter Tip ◽  
Catheter Malposition ◽  
Multiple Conditions

Central venous catheters are frequently placed to facilitate the care of patients with multiple conditions, often via jugular approach. Occasionally, the catheter tip can migrate after placement and become positioned within the azygos arch. This abnormal catheter positioning can lead to an increased number of complications, including catheter malfunction, thrombosis, or even rupture of the azygos vein requiring surgical intervention. Although invasive repositioning of the catheter is always an option, minimally invasive options can be attempted to repair azygos catheter malposition. Fortunately, noninvasive maneuvers, including manipulation of the port on the skin and patient breathing instructions, can sometimes repair the malpositioned catheter.

Pitfall in Pediatric Dialysis: Malposition of a Dialysis Catheter Mimicking Azygos Continuation Syndrome

2007 ◽  
Vol 8 (4) ◽  
pp. 302-304 ◽  
Author(s):  
A.W. Demant ◽  
H. Rattunde ◽  
S. Abderhalden ◽  
R. Von Vigier ◽  
R.W. Wolf
Keyword(s):  
Vascular Access ◽  
Dialysis Patient ◽  
Azygos Vein ◽  
Central Venous Catheters ◽  
Dialysis Catheter ◽  
Central Venous ◽  
Pediatric Dialysis ◽  
Vein System ◽  
Azygos Continuation ◽  
Catheter Malposition

Central venous catheters are established as vascular access in hemodialysis therapy. Vascular catheter misdirection may occur and is a well known problem. We present a rare catheter malposition in a young dialysis patient with consequent dilatation of the azygos vein system, simulating the appearance of an azygos continuation syndrome (ACS).

Recurrent central venous catheter migration in a patient with brittle asthma

2019 ◽  
Vol 21 (4) ◽  
pp. 533-535
Author(s):  
Emily R Hignell ◽  
Julian Phelps
Keyword(s):  
Central Venous Catheter ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
High Index ◽  
Central Venous ◽  
Premature Failure ◽  
Catheter Migration ◽  
Catheter Tip ◽  
History Of ◽  
High Index Of Suspicion

Central venous catheters are widely used in intensive care and critically unwell patients, and reporting of unusual complications is in the interest of those using them on a regular basis. Recognised complications involve vascular, cardiac and pulmonary systems and include the risk of infection. Described is a case with a recurrent complication of device failure secondary to migration of the central venous catheter tip as a result of recurrent coughing episodes. The approach to inserting central catheters and diagnosing the cause for the migration is discussed. This case directly demonstrated looping and significant movement of a polyurethane catheter as a result of coughing. On two occasions, this resulted in the tip migration and the catheter becoming kinked, causing premature failure of the central venous catheter. This has only been seen before with silicone catheters. There should be high index of suspicion for migration of central venous catheters in patients with history of cough. Recommendations include maintaining a high index of suspicion for migration of central venous catheters in patients with history of cough and insertion of larger French size catheters in patient groups prone to severe coughing episodes. Ways to optimise initial central venous catheter placement using intracavitary electrocardiogram should be considered along with the use of interventional radiology in complex cases and those with recurrent complications.

A bedside rescue method for retrieving retained guidewires: The ‘Suck Out’ technique

2020 ◽  
pp. 112972982094345
Author(s):  
Maryanne Z A Mariyaselvam ◽  
Vikesh Patel ◽  
Adam Sawyer ◽  
James A Richardson ◽  
Jonathan Dean ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
Patient Harm ◽  
Central Venous ◽  
Exact Test ◽  
The United Kingdom ◽  
Catheter Tip ◽  
Never Event ◽  
Benchtop Model

Background: Central venous catheter guidewire retention is classed as a ‘never event’ in the United Kingdom, with the potential for significant patient harm. If the retained guidewire remains within the central venous catheter lumen, bedside techniques may facilitate guidewire retrieval. However, these techniques may be ineffective if the guidewire has already passed below skin level. We investigated a novel ‘suck out’ technique for bedside guidewire retrieval and compared this against traditional retrieval methods. Methods: Simulation 1: in a benchtop model, seven different central venous catheters had their corresponding guidewire placed in the last 2 cm of the catheter tip which was immersed horizontally in fluid. A 50-mL syringe was attached to the distal lumen central venous catheter hub and suction applied for 5 s, and the distance of guidewire retraction was recorded. Simulation 2: a central venous catheter guidewire was intentionally retained within the catheter at either 5 cm above or below skin level in a pigskin model. Simple catheter withdrawal, catheter clamping withdrawal and the ‘suck out’ method were compared for efficacy using Fisher’s exact test. Results: Simulation 1: retained guidewires were retracted by 13 cm on average. Simulation 2: when guidewires were retained 5 cm above skin level, all retrieval methods were 100% effective; however, when retained 5 cm below skin level, simple catheter withdrawal was ineffective, clamping and withdrawal was only 10% effective and the ‘suck out’ technique was 90% effective (p < 0.001). Conclusion: The ‘suck out’ technique can effectively retract guidewires retained within central venous catheter lumens and demonstrates superiority over traditional methods of retained guidewire extraction in simulated models.

scholarly journals The Position of Central Venous Catheters Inserted through Arm Veins: A Preliminary Report

1974 ◽  
Vol 2 (1) ◽  
pp. 43-47 ◽  
Author(s):  
D. G. Woods ◽  
Jean Lumley ◽  
W. J. Russell ◽  
R. D. Jack
Keyword(s):  
Preliminary Report ◽  
Heart Surgery ◽  
Venous Pressure ◽  
Venous Blood ◽  
Open Heart Surgery ◽  
Central Venous Catheters ◽  
Open Heart ◽  
Central Venous ◽  
Central Venous Blood ◽  
Catheter Tip

Fifty-three central venous catheters were followed up by radiography or direct observation during open-heart surgery. Forty of these were satisfactorily positioned for recording central venous pressure or for sampling central venous blood. Radiography showed that the catheter tip was in an unsatisfactory position in 21 per cent of cases. It is recommended that radiographic confirmation of the site of the catheter tip be obtained as a routine and if necessary the catheter can be re-positioned and another radiograph taken.

Central venous catheters and arrhythmia: Two unusual cases

2020 ◽  
pp. 112972982091532
Author(s):  
R Haridian Sosa Barrios ◽  
David Lefroy ◽  
Damien Ashby ◽  
Neill Duncan
Keyword(s):  
Real Time ◽  
High Velocity ◽  
Central Venous Catheters ◽  
Fluoroscopic Guidance ◽  
Common Complication ◽  
Central Venous ◽  
Insertion Procedure ◽  
Catheter Tip ◽  
Life Threatening ◽  
Tip Position

Jugular Tesio lines (TesioCaths; MedCOMP, Harleysville, PA, USA) are frequently used as permanent vascular accesses in haemodialysis patients. During the insertion procedure, arrhythmias are a relatively common complication, usually related to an excessively advanced catheter tip, without major consequences. We present two cases of life-threatening arrhythmias triggered by the Tesio catheter eccentric high-velocity jet of blood resolved after reposition of the catheter without further episodes, despite both lines being inserted under real-time ultrasound and fluoroscopic guidance. We believe dialysis lines should be checked for tip position even when long-standing to prevent relevant complications due to catheter sliding.

Ultrasound-guided double central venous access for azygos vein via the ninth and tenth intercostal veins

2020 ◽  
pp. 112972982093713
Author(s):  
Koichiro Yoshimaru ◽  
Toshiharu Matsuura ◽  
Yasuyuki Uchida ◽  
Keisuke Kajihara ◽  
Yukihiro Toriigahara ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
General Anesthesia ◽  
Small Bowel Transplantation ◽  
Vena Cava ◽  
Azygos Vein ◽  
Venous Access ◽  
Positive Pressure ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Invasive Approach

Some patients with intestinal failure, who are dependent on total parenteral nutrition for long periods, suffer from a lack of suitable conventional venous access points, including axillary, external jugular, internal jugular, subclavian, saphenous, and the brachio-cephalic and femoral veins, due to their occlusion. Furthermore, extensive central venous stenosis and/or thrombosis of the superior and inferior vena cava may preclude further catheterization, so uncommon routes must be used, which can be challenging. In such patients, the azygos vein via the intercostal vein is a viable candidate. Thoracotomy-assisted, thoracoscopy-assisted, and cut-down procedures are currently suggested such access. We found that ultrasound-guided percutaneous puncture method was a safe and minimally invasive approach and successfully placed two central venous lines in preparation for small bowel transplantation via two different intercostal veins (ninth and tenth). Although the lung was actually located just below the target veins, an ultrasound provided augmented and clear vision, which contributed to the safe performance of the procedure without the need for invasive surgical intervention, such as thoracotomy, thoracoscopy, or rib resection using the cut-down technique. Furthermore, constant positive-pressure ventilation during vein puncture under general anesthesia also helps avoid venous collapse. Despite carrying a slight risk of light injury to the lung, artery, and nerve along with the vein compared to other procedures, we believe that ultrasound-guided puncture under general anesthesia is feasible as a minimally invasive method.

Clinical usefulness of catheter-drawn blood samples and catheter-tip cultures for the diagnosis of catheter-related bloodstream infections in neonates

2020 ◽  
Vol 41 (7) ◽  
pp. 854-856
Author(s):  
Janita Ferreira ◽  
Paulo Augusto Moreira Camargos ◽  
Viviane Rosado ◽  
Leni Márcia Anchieta ◽  
Roberta Maia de Castro Romanelli
Keyword(s):  
Adverse Events ◽  
Bloodstream Infection ◽  
Efficient Method ◽  
Bloodstream Infections ◽  
Central Venous Catheters ◽  
Blood Sampling ◽  
Central Venous ◽  
Blood Samples ◽  
Catheter Tip ◽  
Catheter Related Bloodstream Infection

AbstractCatheter-drawn blood sampling is an efficient method of diagnosing catheter-related bloodstream infection (CRBSI) in neonates; it has greater sensitivity and accuracy than methods using catheter-tip cultures. No association was detected between catheter-drawn blood sampling and the occurrence of adverse events with central venous catheters.

Migration of Central Venous Catheters: Implications for Initial Catheter Tip Positioning

1997 ◽  
Vol 8 (3) ◽  
pp. 443-447 ◽  
Author(s):  
Christopher M. Kowalski ◽  
John A. Kaufman ◽  
S. Mitchell Rivitz ◽  
Stuart C. Geller ◽  
Arthur C. Waltman
Keyword(s):  
Central Venous Catheters ◽  
Central Venous ◽  
Catheter Tip
Sign in / Sign up

Export Citation Format

Share Document