Minimally Invasive Echo-Guided Placement Of The Cardiac Tube In A Ventriculoatrial Shunt During Pregnancy: Technical Note

2007 ◽  
Vol 61 (suppl_5) ◽  
pp. ONSE398-ONSE398
Author(s):  
Licia Di Muro ◽  
Roberto Pallini ◽  
Domenico Pietrini ◽  
Christian Colizzi ◽  
Luca Denaro
Keyword(s):  
Minimally Invasive ◽  
Internal Jugular Vein ◽  
Right Atrium ◽  
Jugular Vein ◽  
Technical Note ◽  
Invasive Technique ◽  
Success Rates ◽  
Ventriculoatrial Shunt ◽  
Simple Method ◽  
Sonographic Guidance

Abstract Objective: We describe a minimally invasive echo-guided placement of the cardiac tube in a ventriculoatrial shunt in a young pregnant woman, in order to avoid any radiological procedure. Methods: We used a central venous catheter placement kit for percutaneous echo-guided right internal jugular vein puncture located by a 7.5 mHz microlinear probe. Through the catheter, the distal portion of the shunt device was positioned into the internal jugular vein to the right atrium using ultrasound control by a 2.5 to 3.5 mHz probe in a four-chamber transthoracic view. Results: Sonographic guidance in percutaneous placement of a vertebral artery shunt is a safe and fast minimally invasive technique that improves success rates and decreases complications such as incidental puncture of the carotid artery and pneumothorax. The use of a two-dimensional echocardiographic apparatus in a four-chamber transthoracic view is an accurate and simple method to verify the position of the distal tip of the shunt in the mid-right atrium with no risks for the patient. Conclusion: The use of these two techniques allows a minimally invasive, safe, accurate, and complete x-ray-free procedure.

Placement of a Ventriculoatrial Shunt Using External Jugular Catheterization: Technical Note

Neurosurgery ◽  
1984 ◽  
Vol 14 (1) ◽  
pp. 74-75 ◽  
Author(s):  
Tadanori Tomita
Keyword(s):  
Right Atrium ◽  
Jugular Vein ◽  
Technical Note ◽  
External Jugular Vein ◽  
Ventriculoatrial Shunt ◽  
Young Infants ◽  
Atrial Catheter ◽  
The Right

Abstract A technique for the insertion of the atrial end of a ventriculoatrial shunt is described. The technique utilizes a J-wire and an open end atrial catheter inserted through the external jugular vein into the right atrium under fluoroscopy. It is safe and effective, even in young infants.

scholarly journals Transulcal parafascicular minimally invasive approach to deep and subcortical cavernomas: technical note

2016 ◽  
Vol 125 (6) ◽  
pp. 1360-1366 ◽  
Author(s):  
Robert A. Scranton ◽  
Steve H. Fung ◽  
Gavin W. Britz
Keyword(s):  
White Matter ◽  
Minimally Invasive ◽  
Technical Difficulty ◽  
Subcortical White Matter ◽  
Technical Note ◽  
Vascular Lesions ◽  
Invasive Technique ◽  
Minimally Invasive Approach ◽  
Unique Challenge ◽  
Invasive Approach

Cavernomas comprise 8%–15% of intracranial vascular lesions, usually supratentorial in location and superficial. Cavernomas in the thalamus or subcortical white matter represent a unique challenge for surgeons in trying to identify and then use a safe corridor to access and resect the pathology. Previous authors have described specific open microsurgical corridors based on pathology location, often with technical difficulty and morbidity. This series presents 2 cavernomas that were resected using a minimally invasive approach that is less technically demanding and has a good safety profile. The authors report 2 cases of cavernoma: one in the thalamus and brainstem with multiple hemorrhages and the other in eloquent subcortical white matter. These lesions were resected through a transulcal parafascicular approach with a port-based minimally invasive technique. In this series there was complete resection with no neurological complications. The transulcal parafascicular minimally invasive approach relies on image interpretation and trajectory planning, intraoperative navigation, cortical cannulation and subcortical space access, high-quality optics, and resection as key elements to minimize exposure and retraction and maximize tissue preservation. The authors applied this technique to 2 patients with cavernomas in eloquent locations with excellent outcomes.

Safe Placement of Central Venous Catheters

2011 ◽  
Vol 26 (6) ◽  
pp. 392-396 ◽  
Author(s):  
William T. McGee ◽  
Patrick T. Mailloux ◽  
Richard T. Martin
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Superior Vena ◽  
Prospective Trial ◽  
Vena Cava ◽  
Pericardial Tamponade ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Insertion Depth ◽  
Simple Method

Introduction. To develop a simple method for safely placing central venous catheters (CVCs) outside the heart from the subclavian or internal jugular vein in compliance with Food and Drug Administration (FDA) and manufacturer guidelines. Methods. Patients requiring CVCs were enrolled into this prospective trial. Central venous catheters were inserted into the subclavian or internal jugular vein from either the right or left side to a depth of 15 cm. Chest radiographs were obtained immediately after insertion of the catheter to check tip placement and to evaluate for mechanical complications. Results. Operators successfully placed 201 of 210 (96%) CVCs outside the heart. Six of these required repositioning. Nine catheter tips were located in an intracardiac position. No cases of pneumothorax, hemothorax, or pericardial tamponade occurred. One case of delayed hydrothorax due to superior vena cava injury occurred. Conclusions. Using a 15-cm insertion depth via the internal jugular or subclavian vein results in safe catheter tip location in the majority of procedures consistent with FDA and manufacturer guidelines.

scholarly journals Ultrasound-guided anatomical evaluation and percutaneous cannulation of the right internal jugular vein in infants <4000 g

2019 ◽  
Vol 21 (1) ◽  
pp. 92-97 ◽  
Author(s):  
Filiz Uzumcugil ◽  
Aysun Ankay Yilbas ◽  
Basak Akca
Keyword(s):  
Carotid Artery ◽  
Real Time ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Anatomical Variation ◽  
Complication Rates ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Vein Access ◽  
The Right

Background: The commonly preferred right internal jugular vein was investigated in terms of its dimensions, the relationship between its dimensions and anthropometric measures, and the outcomes of its cannulation in infants. Data regarding its position with respect to the carotid artery indicated anatomical variation. Aim: The aim of this study was to share our observations pertaining to the anatomy and position of the right internal jugular vein with respect to carotid artery using ultrasound and our experience with ultrasound-guided right internal jugular vein access in neonates and small infants. Materials and methods: A total of 25 neonates and small infants (<4000 g) undergoing ultrasound-guided central venous cannulation via right internal jugular vein within a 6-month period were included. Ultrasound-guided anatomical evaluation of the vein was used to obtain the transverse and anteroposterior diameters, the depth from skin and the position with respect to the carotid artery. Real-time ultrasound-guided central cannulation success rates and complication rates were also obtained. The patients were divided into two groups with respect to their weight in order to compare both the position and the dimensions of right internal jugular vein and cannulation performance in infants weighing <2500 g and ⩾2500 g. Results: The position was lateral to the carotid artery in 84% of all infants and similar in both groups. The first-attempt success rates of cannulation were similar (70% vs 73.3%) in both groups, with an overall success rate of 88%. Conclusion: Right internal jugular vein revealed a varying position with respect to carotid artery with a higher rate of lateral position. The presence of such anatomical variation requires ultrasonographic evaluation prior to interventions and real-time guidance during interventions involving right internal jugular vein.

Pre-procedural ultrasound-guided evaluation of left internal jugular vein and brachiocephalic vein: Experience on infants <1 year

2020 ◽  
pp. 112972982092569
Author(s):  
Filiz Uzumcugil
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Present Report ◽  
Brachiocephalic Vein ◽  
Complication Rates ◽  
Success Rates ◽  
Left Internal Jugular Vein ◽  
Ultrasound Guided ◽  
First Choice ◽  
Plane Technique

Pre-procedural evaluation of central veins prior to cannulation with ultrasound is essential to reduce the complication rates as well as to increase the success rates. The left brachiocephalic vein has been suggested to be considered as first choice in infants including the neonates due to its larger diameter and ease of access with supraclavicular, ultrasound-guided, in-plane technique. There are few studies on neonates and infants comparing the diameter of brachiocephalic vein with internal jugular vein being its most common alternative. The aim of the present report is to share our observations pertaining to the pre-procedural measurements of the diameters of left internal jugular vein and brachiocephalic vein in infants <1 year. The measurements were analysed in accordance with the weights of the infants (<2500 g and ⩾2500 g). In infants <2500 g, the brachiocephalic vein was larger than the internal jugular vein (4.0 ± 0.7 (3.2–5.2) mm vs 3.2 ± 0.7 (1.9– 4.3) mm, p = 0.032), whereas the diameters of two major veins were similar in infants ⩾2500 g (4.8 ± 1.2 (2.3–6.4) mm vs 5.1 ± 0.9 (2.8–6.7) mm, p = 0.363). Our observations support the suggestion of the brachiocephalic vein to be considered as the first choice for large-bore cannulation due to its larger diameter as well as its other advantages, especially in neonates <2500 g.

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