Sharp Recanalization of a Chronically Occluded Superior Vena Cava in a Patient with Multiple Prior Peripherally Inserted Central Catheters

2019 ◽  
Vol 24 (2) ◽  
pp. 21-26
Author(s):  
Omar Shwaiki ◽  
Sarah Khoncarly ◽  
James J. Buchino ◽  
Janice McDaniel
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Access ◽  
Collateral Flow ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Sharp Recanalization ◽  
Central Catheters

Highlights Recurrent central venous access can lead to central venous occlusions. Collateral flow can be used adventitiously for PICC tip placement. Sharp recanalization can be used to reconstitute patency of an occluded SVC.

scholarly journals Superior Vena Cava Duplication: The Red Herring of Central Line Placement

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Karin Gunther ◽  
Carmen Lam ◽  
David Siegel
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Catheter ◽  
Venous Access ◽  
The United States ◽  
Central Line ◽  
Central Venous ◽  
Central Venous Access Lines

5 million central venous access lines are placed every year in the United States, and it is a common surgical bedside procedure. We present a case of a central venous catheter placement with port for chemotherapy use, during which a duplication of a superior vena cava was discovered on CTA chest after fluoroscopy could not confirm placement of the guidewire. Due to its potential clinical implications, superior vena cava duplication must be recognized when it occurs.

Placement of Central Venous Catheters in Patients Undergoing Major Maxillofacial Surgery - A Retrospective Clinical Audit

2010 ◽  
Vol 11 (2) ◽  
pp. 128-131
Author(s):  
Vasileios Zochios ◽  
Michael Gilhooly ◽  
Simon Fenner
Keyword(s):  
Central Venous Catheter ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Central Venous Access ◽  
Maxillofacial Surgery ◽  
Vena Cava ◽  
Venous Catheter ◽  
Venous Access ◽  
Central Venous Catheters ◽  
Central Venous

Purpose The subclavian vein is thought to be the most appropriate route for central venous access in major maxillofacial surgery. Evidence suggests that left-sided central venous catheters should lie below the carina and be angulated at less than 40° to superior vena cava wall. This reduces perforation risk. With this in mind we audited our current practice for placement of central venous catheters for major maxillofacial surgery. The criteria against which we compared our practice were: 1) all catheter tips should lie below the carina and 2) the angle of the distal 1 cm of the catheter should be no more than 40° to the superior vena cava wall. Methods Left subclavian central venous catheters placed on a weekly operating list between September 2005 and August 2008 were identified retrospectively: 83 patients were identified; 22 were excluded. The angle of the central venous catheter tip and distance from the carina were measured on the first post-procedure chest-X ray. All central venous catheters used were 16 cm long. Results 82% of the catheter tips were located above the carina while 61% were angulated at greater than 40°; 11% of central venous catheters met both standards; 14% of central venous catheters placed by a consultant and 12% of catheters placed by a trainee met both standards. Conclusions 89% of the central venous catheters were not correctly placed. The majority of central venous catheter tips above the carina were at an adverse angle to the superior vena cava wall. We suggest that for left subclavian central lines, 20 cm catheters be used.

scholarly journals PERSISTENT LEFT SUPERIOR VENA CAVA IDENTIFIED DURING CENTRAL VENOUS ACCESS

CHEST Journal ◽  
2021 ◽  
Vol 160 (4) ◽  
pp. A927
Author(s):  
Huda Asif ◽  
Stanislav Ivanov ◽  
Arsalan Wappi ◽  
Katherine Hodgin ◽  
Adam Friedlander ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Access ◽  
Central Venous ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena

Central venous access into the left superior vena cava

2006 ◽  
Vol 30 (4) ◽  
pp. 433-434
Author(s):  
Klementyna M. Breyer ◽  
Brian J. Levine
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Access ◽  
Central Venous ◽  
Left Superior Vena Cava

Central Venous Access through a Persistent left Superior Vena Cava: A Case Series

2016 ◽  
Vol 17 (5) ◽  
pp. e143-e147 ◽  
Author(s):  
Qiao Zhou ◽  
Shashi Murthy ◽  
Alex Pattison ◽  
Gabriel Werder
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Case Series ◽  
Venous Access ◽  
Central Venous ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena

Placement of Tunnelled Hemodialysis Catheters across Stenotic and Occluded Central Veins

2003 ◽  
Vol 4 (1) ◽  
pp. 3-8 ◽  
Author(s):  
A. Falk ◽  
A. Alomari ◽  
J.E. Silberzweig
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Access ◽  
Catheter Insertion ◽  
Brachiocephalic Vein ◽  
Metallic Stent ◽  
Central Venous ◽  
Hemodialysis Catheter

Purpose The purpose of this study was to evaluate the efficacy of placement of tunneled hemodialysis catheters in patients with occluded or stenotic central veins. Materials and Methods Data were prospectively collected for 26 patients (11 male, 15 female, mean age 52 years) referred for placement of tunneled hemodialysis catheters with central venous stenoses or occlusions. The central venous occlusions or stenoses were recanalized using traditional interventional catheter and guidewire techniques. Results Thirty central venous access procedures were performed of which 28 (93%) procedures resulted in successful tunneled catheter insertion. Twenty-one internal jugular venous (13 right, 8 left) and 7 subclavian venous (3 right, 4 left) catheters were placed. Eighteen stenotic and 10 occluded venous segments were crossed including the brachiocephalic vein (n = 22), subclavian vein (n = 2), and the superior vena cava (4). One patient required insertion of a metallic stent to facilitate passage of the hemodialysis catheter across an occluded brachiocephalic vein. No procedure-related complications occurred. No episodes of upper extremity swelling or superior vena cava syndrome occurred following catheter insertion. Conclusion Insertion of tunneled hemodialysis catheter across occluded or stenotic central veins is technically feasible and safe. The use of occluded or stenotic central veins for catheter access preserves patent central veins for future shunt access.

Repositioning of Central Venous Access Devices using a High-Flow Flush Technique - a Clinical Practice and Cost Review

2017 ◽  
Vol 18 (5) ◽  
pp. 419-425 ◽  
Author(s):  
Timothy R. Spencer
Keyword(s):  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Access ◽  
High Flow ◽  
Cost Comparison ◽  
Central Venous ◽  
Access Service ◽  
Venous Access Device ◽  
Central Catheters

Background Malpositioned central venous access device (CVAD) tip locations can cause significant mechanical and chemical vessel-related injuries and complications if left in inappropriate positions. The aim of this study is to determine the use of a high-flow flush technique (HFFT) in successful correction of malpositioned catheters into the lower superior vena cava or cavoatrial junction and provide a cost comparison to interventional/fluoroscopic-based repositioning. Methods This is a retrospective chart and radiographic review of all inserted CVADs found malpositioned between 1996-2014 in a multi-specialty 1000-bed tertiary trauma center in Sydney, Australia. 7450 CVADs placed by a nurse-led vascular access service were reviewed. Catheters repositioned pre-2010 were excluded owing to radiology repositioning interventions. Results There were 3996 peripherally inserted central catheters (PICCs) and 3454 centrally inserted central catheters (CICCs) placed. Seventy-four were malpositioned post-2010. Of these, 53 devices were repositioned using the studied technique; 86% (46/53) of catheters were successfully repositioned on the first HFFT attempt. There was supportive evidence that device insertion side is important in potential catheter malposition. Conclusions Clinical outcomes suggest that CICCs and PICCs may be successfully repositioned utilizing this technique, with no adverse events associated and a prospective cost saving benefit when compared to interventional-based repositioning procedures.

scholarly journals Paradoxical Cerebral Embolism Secondary to Superior Vena Cava Occlusion and Development of a Systemic Right-to-Left Shunt

2021 ◽  
Author(s):  
Ronny J.D. Kuang ◽  
Anna L Beale ◽  
Jason E Bloom ◽  
Warren Clements
Keyword(s):  
Superior Vena Cava ◽  
Pulmonary Circulation ◽  
Coil Embolization ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Access ◽  
Systemic Circulation ◽  
Cerebral Embolism ◽  
Central Venous

AbstractParadoxical cerebral embolism, although rare, can be secondary to acquired causes such as superior vena cava (SVC) occlusion and development of a mediastinal right-to-left shunt. Such shunts allow undisturbed passage of thromboemboli to bypass the pulmonary circulation and enter the systemic circulation. This report presents a case of paradoxical cerebral embolism due to a right-to-left shunt originating from occlusion of the SVC. The etiology of the SVC occlusion stems from a prior central venous access line used for treatment of lymphoma. The patient underwent endovascular treatment with successful coil embolization of the mediastinal shunt.

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