A central venous catheter in the right vertebral vein.

Abstract Background Cannulation of a central venous catheter is sometimes associated with serious complications. When arterial cannulation occurs, attention must be given to removal of a catheter. Case presentation A 62-year-old man was planned for emergency thoracic endovascular aortic repair. After the induction of anesthesia, a central venous catheter was unintentionally inserted into the right subclavian artery. We planned to remove the catheter. Since we considered that surgical repair would be highly invasive for the patient, we decided to remove it using a percutaneous intravascular stent. A stent was inserted through the right axillary artery. The stent was expanded immediately after the catheter was removed. Post-procedural angiography revealed no leakage from the catheter insertion site and no occlusion of the right subclavian and vertebral arteries. There were no obvious hematoma or thrombotic complications. Conclusions A catheter that has been misplaced into the right subclavian artery was safely removed using an intravascular stent.

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ECG-guided central venous catheter positioning: does it detect the pericardial reflection rather than the right atrium?

European Journal of Anaesthesiology ◽

10.1017/s0265021504008038 ◽

2004 ◽

Vol 21 (8) ◽

pp. 600-605 ◽

Cited By ~ 1

Author(s):

W. Schummer ◽

C. Schummer ◽

A. Müller ◽

J. Steenbeck ◽

J. Fuchs ◽

...

Keyword(s):

Central Venous Catheter ◽

Right Atrium ◽

Venous Catheter ◽

Central Venous ◽

The Right

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

Journal of International Medical Research ◽

10.1177/0300060518813514 ◽

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.

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Central Venous Catheter in the Right Vertebral Vein

Internal Medicine ◽

10.2169/internalmedicine.52.0527 ◽

2013 ◽

Vol 52 (15) ◽

pp. 1763-1763

Author(s):

Shun Kishimoto ◽

Toshiyuki Arai

Keyword(s):

Central Venous Catheter ◽

Venous Catheter ◽

Central Venous ◽

The Right

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

The Journal of Vascular Access ◽

10.1177/1129729818757976 ◽

2018 ◽

Vol 19 (6) ◽

pp. 528-534 ◽

Cited By ~ 5

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.

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Picking the Right Tool for the Job: A Reliability Study of 4 Assessment Tools for Central Venous Catheter Insertion

Journal of Graduate Medical Education ◽

10.4300/jgme-d-19-00107.1 ◽

2019 ◽

Vol 11 (4) ◽

pp. 422-429

Author(s):

Jason A. Lord ◽

Danny J. Zuege ◽

Maria Palacios Mackay ◽

Amanda Roze des Ordons ◽

Jocelyn Lockyer

Keyword(s):

Intensive Care ◽

Central Venous Catheter ◽

Rating Scales ◽

Assessment Tool ◽

Generalizability Theory ◽

Venous Catheter ◽

Assessment Tools ◽

Global Rating ◽

Central Venous ◽

The Right

ABSTRACT Background Determining procedural competence requires psychometrically sound assessment tools. A variety of instruments are available to determine procedural performance for central venous catheter (CVC) insertion, but it is not clear which ones should be used in the context of competency-based medical education. Objective We compared several commonly used instruments to determine which should be preferentially used to assess competence in CVC insertion. Methods Junior residents completing their first intensive care unit rotation between July 31, 2006, and March 9, 2007, were video-recorded performing CVC insertion on task trainer mannequins. Between June 1, 2016, and September 30, 2016, 3 experienced raters judged procedural competence on the historical video recordings of resident performance using 4 separate tools, including an itemized checklist, Objective Structured Assessment of Technical Skills (OSATS), a critical error assessment tool, and the Ottawa Surgical Competency Operating Room Evaluation (O-SCORE). Generalizability theory (G-theory) was used to compare the performance characteristics among the tools. A decision study predicted the optimal testing environment using the tools. Results At the time of the original recording, 127 residents rotated through intensive care units at the University of Calgary, Alberta, Canada. Seventy-seven of them (61%) met inclusion criteria, and 55 of those residents (71%) agreed to participate. Results from the generalizability study (G-study) demonstrated that scores from O-SCORE and OSATS were the most dependable. Dependability could be maintained for O-SCORE and OSATS with 2 raters. Conclusions Our results suggest that global rating scales, such as the OSATS or the O-SCORE tools, should be preferentially utilized for assessment of competence in CVC insertion.

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