Influence of venipuncture point and port chamber site on the risk of catheter fracture in right internal jugular port placements

2019 ◽  
Vol 20 (6) ◽  
pp. 666-671 ◽  
Author(s):  
Kazuya Matsunari ◽  
Kota Watanabe ◽  
Norihiro Hishizume ◽  
Hidefumi Fujisawa
Keyword(s):  
Lower Risk ◽  
Jugular Vein ◽  
Curvature Radius ◽  
Central Venous ◽  
Port Placement ◽  
Port Implantation ◽  
Catheter Group ◽  
Tip Position ◽  
The Right ◽  
Catheter Fracture

Background: For subcutaneously implanted central venous ports, some complications due to prolonged placement have been reported. We investigated the appropriate puncture points and port placement sites to prevent catheter fracture in right internal jugular port placement. Methods: This retrospective study included 709 patients who underwent right internal jugular vein puncture and port implantation in the right precordium between 1 May 2012 and 31 March 2018. The cases were divided into undamaged catheter group and damaged catheter group comprising normal and fracture cases, respectively. The catheter angle, distance from the clavicle, tip position, and curvature radius were measured from fluoroscopic images obtained at the time of implantation. The t-test was used in statistical analysis. Results: Median angles were 91.6° in the undamaged catheter group and 58.0° in the damaged catheter group. Median distances were 26.0 mm in the undamaged catheter group and 36.6 mm in the damaged catheter group. Median tip positions were 51.6 mm in the undamaged catheter group and 37.5 mm in the damaged catheter group. Median curvature radii were 9.2 R in the undamaged catheter group and 7.1 R in the damaged catheter group. Significant differences were found in the angle, height, and curvature radius between the two groups. Conclusion: Our results indicate that a venipuncture as close to the clavicle as possible (less than 3 cm) and a gentle catheter curve (close to 90° angle) are associated with a lower risk of catheter fracture.

scholarly journals Port Placement via the Anterior Jugular Venous System: Case Report, Anatomic Considerations, and Literature Review

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Gernot Rott ◽  
Frieder Boecker
Keyword(s):  
Jugular Vein ◽  
Central Venous Access ◽  
Venous Access ◽  
Venous System ◽  
Port Catheter ◽  
Central Venous ◽  
Port Placement ◽  
Total Occlusion ◽  
Port Implantation ◽  
The Right

We report on a patient who was referred for port implantation with a two-chamber pacemaker aggregate on the right and total occlusion of the central veins on the left side. Venous access for port implantation was performed via left side puncture of the horizontal segment of the anterior jugular vein system (AJVS) and insertion of the port catheter using a crossover technique from the left to the right venous system via the jugular venous arch (JVA). The clinical significance of the AJVS and the JVA for central venous access and port implantation is emphasised and the corresponding literature is reviewed.

Misplacement of a central venous catheter into azygos vein via the right internal jugular vein

2020 ◽  
pp. 112972982095099
Author(s):  
Minjia Wang ◽  
Liang Xu ◽  
Yue Feng ◽  
Shijin Gong
Keyword(s):  
Central Venous Catheter ◽  
Critically Ill Patients ◽  
Central Venous Catheterization ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Azygos Vein ◽  
Central Venous ◽  
Venous Catheterization ◽  
Tip Position ◽  
The Right

For critically ill patients, central venous catheterization may not always be placed in a correct tip position, even when guided by ultrasound. A case of inadvertent catheterization into azygos vein is described.

scholarly journals Lancisi’s sign and central venous catheter tip position: a case report

2018 ◽  
Vol 19 (1) ◽  
pp. 92-93
Author(s):  
Valentina Vigo ◽  
Piero Lisi ◽  
Giuseppe Galgano ◽  
Carlo Lomonte
Keyword(s):  
Case Report ◽  
Central Venous Catheter ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Central Venous ◽  
Catheter Tip ◽  
Tip Position ◽  
The Right ◽  
Venous Pulse

Introduction: Valvular disease and pulmonary hypertension are common conditions in haemodialysis patients. In presence of tricuspid regurgitation, an increased retrograde blood flow into the right atrium during ventricle systole results in a typical modification of the normal venous waveform, creating a giant c-v wave. This condition clinically appears as a venous palpable pulsation within the internal jugular vein, also known as Lancisi’s sign. Case report: An 83-year-old woman underwent haemodialysis for 9 years. After arteriovenous fistula thrombosis, a right internal jugular vein non-tunnelled central venous catheter (CVC) was placed. About one month later, the patient was referred to our facility for the placement of a tunnelled CVC. Neck examination revealed an elevated jugular venous pulse, the Lancisi’s sign. Surprisingly, chest x-ray posteroanterior view showed the non-tunnelled catheter tip in correspondence with the right ventricle. She underwent surgery for temporary to tunnelled CVC conversion using the same venous insertion site (Bellcath®10Fr-length 25 cm to Mahurkar®13.5Fr-length 19 cm). In the postoperative period, we observed a significant reduction of the jugular venous pulse. Discussion: The inappropriate placement of a 25-cm temporary CVC in the right internal jugular vein worsened the tricuspid valve regurgitation, which became evident by the Lancisi’s sign. Removal of the temporary CVC from the right ventricle resulted in improved right cardiac function. Safe approaches recommended by guidelines for the CVC insertion technique and for checking the tip position should be applied in order to avoid complications.

Ideal Position of Central Venous Catheters: Length of Catheter in Relation to Height of Patient

1994 ◽  
Vol 2 (2) ◽  
pp. 87-89
Author(s):  
Kanchi Muralidhar ◽  
Krishna Acharya ◽  
Prasantha Dash
Keyword(s):  
Jugular Vein ◽  
Central Venous Catheters ◽  
Seldinger Technique ◽  
Central Venous ◽  
Ideal Position ◽  
Catheter Tip ◽  
Group A ◽  
Tip Position ◽  
Group B ◽  
The Right

One hundred patients of either sex undergoing elective cardiac operation were divided randomly into 2 groups. In both groups, the right internal jugular vein was cannulated using the Seldinger technique and multilumen central venous catheters. The length of catheter inserted in Group A was height of the patient in centimeters divided by 10, and Group B height in centimeters divided by 12. Ideal catheter tip position could be obtained in 94% of the patients in Group B, but only 36% in Group A ( p < 0.001).

scholarly journals Folded large-bore central catheter in the right internal jugular vein as shown by ultrasound: a case report

2018 ◽  
Vol 47 (2) ◽  
pp. 1005-1009
Author(s):  
Taehee Pyeon ◽  
Jeong-Yeon Hwang ◽  
HyungYoun Gong ◽  
Sang-Hyun Kwak ◽  
Joungmin Kim
Keyword(s):  
Central Venous Catheter ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Present Report ◽  
Large Diameter ◽  
Venous Catheter ◽  
Venous Access ◽  
Central Venous ◽  
The Right ◽  
Gain Access

Central venous catheters are used for various purposes in the operating room. Generally, the use of ultrasound to insert a central venous catheter is rapid and minimally complicated. An advanced venous access (AVA) catheter is used to gain access to the pulmonary artery and facilitate fluid resuscitation through the internal jugular vein. The present report describes a case in which ultrasound was used in a 43-year-old man to avoid complications during insertion of an AVA catheter with a relatively large diameter. The sheath of the catheter was so thin that a dilator was essential to prevent it from folding upon insertion. Despite the use of ultrasound guidance, the AVA catheter sheath became folded within the patient’s internal jugular vein. Mechanical complications of central venous catheter insertion are well known, but folding of a large-bore catheter in the internal jugular vein has rarely been reported.

Electrocardiography-controlled central venous catheter tip positioning in patients with atrial fibrillation

2018 ◽  
Vol 19 (6) ◽  
pp. 528-534 ◽  
Author(s):  
Folkert Steinhagen ◽  
Maximilian Kanthak ◽  
Guido Kukuk ◽  
Christian Bode ◽  
Andreas Hoeft ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Central Venous Catheter ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Catheter ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Catheter Tip ◽  
Tip Position ◽  
The Right

Introduction: A significant increase of the p-wave of a real-time intracavitary electrocardiography is a reliable and safe method to confirm the central venous catheter tip position close to the atrium. However, conflicting data about the feasibility of electrocardiography exist in patients with atrial fibrillation. Methods: An observational prospective case–control cohort study was set up to study the feasibility and accuracy of the electrocardiography-controlled central venous catheter tip placement in 13 patients with atrial fibrillation versus 10 patients with sinus rhythm scheduled for elective surgery. Each intervention was crosschecked with ultrasound-guided positioning via right supraclavicular fossa view and chest radiography. Ultrasound-guided supraclavicular venipuncture of the right subclavian vein and guidewire advancement were performed. A B-mode view of the superior vena cava and the right pulmonary artery was obtained to visualize the J-tip of the guidewire. The central venous catheter was advanced over the guidewire and the electrocardiography was derived from the J-tip of the guidewire protruding from the central venous catheter tip. Electrocardiography was read for increased p- and atrial fibrillation waves, respectively, and insertion depth was compared with the ultrasound method. Results: Electrocardiography indicated significantly increasing fibrillation and p-waves, respectively, in all patients and ultrasound-guided central venous catheter positioning confirmed a tip position within the lower third of the superior vena cava. Conclusion: Electrocardiography-guided central venous catheter tip positioning is a feasible real-time method for patients with atrial fibrillation. Combined with ultrasound, the electrocardiography-controlled central venous catheter placement may eliminate the need for postinterventional radiation exposure.

scholarly journals Bloodstream infections among patients using central venous catheters in intensive care units

2007 ◽  
Vol 15 (3) ◽  
pp. 453-459 ◽  
Author(s):  
Eni Rosa Aires Borba Mesiano ◽  
Edgar Merchán-Hamann
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Analytical Study ◽  
Hospital Costs ◽  
Bloodstream Infections ◽  
Federal District ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Catheter Group ◽  
The Right

Central Venous Catheters (CVC), widely used in Intensive Care Units (ICU) are important sources of bloodstream infections (BSI). This prospective cohort epidemiological analytical study, aimed to infer the incidence of BSI, the risk factors associated and evaluate the care actions related to the use of these catheters in seven ICU in the Federal District - Brasília, Brazil. From the 630 patients using CVC, 6.4% developed BSI (1.5% directly related to the catheter and 4.9% clinic BSI). The hospitalization term was 3.5 times greater among these patients. Different modalities of catheter insertion and antiseptic substances use were observed. Time of CVC permanence was significantly associated to infection incidence (p<1x10-8) as well as the right subclavian access and double-lumen catheters. Patients with neurological disorders and those submitted to tracheotomy were the most affected. We suggest the organization of a "catheter group" aiming to standardize procedures related to the use of catheters in order to reduce the hospitalization term and hospital costs.

Migration of a Silastic® central venous catheter into the right jugular vein: report of two cases

1991 ◽  
Vol 10 (3) ◽  
pp. 173-175 ◽  
Author(s):  
T. Chikenji ◽  
M. Mizutani ◽  
M. Yokoyama ◽  
Y. Kitsukawa
Keyword(s):  
Central Venous Catheter ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Central Venous ◽  
The Right
Sign in / Sign up

Export Citation Format

Share Document