The Use of Ultrasound in Central Venous Access in Children

Image-guided central venous access is forming an increasingly large proportion of the workload in interventional radiology following recognition that such techniques are less invasive and often quicker than traditional surgical techniques, with clear benefit in subjects with multiple previous attempts at venous access. Venous access sites are generally superficial in children, allowing excellent quality images during ultrasound-guided puncture and providing a greater number of options when considering the approach to catheter placement. Methods of ultrasound-guided puncture are described and the varieties of catheter devices available are discussed. Other advantages of ultrasound, such as in the assessment of thrombosed vessels and collateral veins, as well as the localization of catheter cuffs within the subcutaneous tissues, are also discussed.

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Ultrasound-guided cannulation of the superficial femoral vein for central venous access

The Journal of Vascular Access ◽

10.1177/11297298211003745 ◽

2021 ◽

pp. 112972982110037

Author(s):

Maria Giuseppina Annetta ◽

Bruno Marche ◽

Laura Dolcetti ◽

Cristina Taraschi ◽

Antonio La Greca ◽

...

Keyword(s):

Inferior Vena ◽

Femoral Vein ◽

Central Venous Access ◽

Vena Cava ◽

Venous Access ◽

Ultrasound Guided ◽

Central Venous ◽

Superficial Femoral Vein ◽

Ultrasound Guided Puncture ◽

Guided Puncture

Background: In some clinical conditions, central venous access is preferably or necessarily achieved by threading the catheter into the inferior vena cava. This can be obtained not only by puncture of the common femoral vein at the groin, but also—as suggested by few recent studies—by puncture of the superficial femoral vein at mid-thigh. Methods: We have retrospectively reviewed our experience with central catheters inserted by ultrasound-guided puncture and cannulation of the superficial femoral vein, focusing mainly on indications, technique of venipuncture, and incidence of immediate/early complications. Results: From June 2020 to December 2020, we have inserted 98 non-tunneled central venous catheters (tip in inferior vena cava or right atrium) by ultrasound-guided puncture of the superficial femoral vein at mid-thigh or in the lower third of the thigh, all of them secured by subcutaneous anchorage. The success of the maneuver was 100% and immediate/early complications were negligible. Follow-up of hospitalized patients (72.5% of all cases) showed only one episode of catheter dislodgment, no episode of infection and no episode of catheter related thrombosis. Conclusions: The ultrasound approach to the superficial femoral vein is an absolutely safe technique of central venous access. In our experience, it was not associated with any risk of severe insertion-related complications, even in patients with low platelet count or coagulation disorders. Also, the exit site of the catheter at mid-thigh may have advantages if compare to the exit site in the inguinal area.

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Management of Catheter-related Complications: Perspective of an Intervention Radiologist

Journal of the Association for Vascular Access ◽

10.2309/1552-8855-10.2.73 ◽

2005 ◽

Vol 10 (2) ◽

pp. 73-76

Author(s):

Thomas M. Vesely

Keyword(s):

Interventional Radiology ◽

Central Venous Access ◽

Venous Access ◽

Central Venous ◽

Image Guided ◽

Access Services

Abstract Interventional radiologists continue to provide an expanding range of central venous access services. Central venous access procedures now constitute nearly 50% of the daily workload in many interventional radiology practices. This article will briefly review the percutaneous, image-guided techniques that interventional radiologists commonly use to evaluate and treat catheter-related problems and complications.

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