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.

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.

Unexpected Complication of Central Venous Catheter Exchange: Catheter Fragment Migration

2020 ◽  
pp. 1-6
Author(s):  
Pan Xie ◽  
Min Tao ◽  
Hongwen Zhao ◽  
Jun Qiu ◽  
Shaohua Li ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Vena Cava ◽  
Venous Catheter ◽  
Central Venous ◽  
Catheter Exchange ◽  
The Right ◽  
Deep Vein ◽  
Gooseneck Snare

Tunneled central venous catheter (TCVC) placement is often an easy and uncomplicated procedure. As such, some clinicians pay little attention to the procedure, and different complications occurred. Catheter fragment loss in major vessels is a rare but serious complication of in situ catheter exchange with few reported cases in the literature. Once catheter fragments slip into a deep vein, endovascular retrieval should be attempted, due to its high success rate and minimal associated morbidity. A 37-year-old male patient underwent replacement of his temporary catheter with TCVC through a trans-right-internal-jugular-vein approach for maintenance of dialysis. As a major unintended outcome of the operation, a catheter fragment slipped into the right internal jugular vein, then migrated and lodged in the inferior vena cava. We retrieved it with a gooseneck snare without complications. We report the case hoping to emphasize on and raise awareness of the fact that catheter fragment loss is a completely evitable complication, provided the operator follows the correct safety measures and protocols. However, if catheter fragment loss occurred, the fragment should be retrieved as soon as possible. A gooseneck snare is an ideal option for retrieving catheter fragments that have migrated into deep veins.

scholarly journals Retrieval of fractured dialysis catheter through phlebotomy of internal jugular vein: a case report

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199889
Author(s):  
Huizhen Wu ◽  
Tapas Ranjan Behera ◽  
Doaa Attia ◽  
Xiaoling Yu ◽  
Quanquan Shen
Keyword(s):  
Central Venous Catheter ◽  
Internal Jugular Vein ◽  
Right Atrium ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Cost Effective ◽  
Central Venous ◽  
Safe Alternative ◽  
Mechanical Fracture ◽  
The Right

A central venous catheter is the most common access for initiating hemodialysis. Prolonged access through a central venous catheter increases the risk of infection and dysfunction of the catheter with potential development of catheter-induced thrombosis and embolism. However, fracture and dislodgement of the catheter with subsequent embolization is an unexpected complication. Endovascular treatment is a promising method to remove intravascular foreign bodies. We herein report a case of a 58-year-old woman undergoing prolonged hemodialysis who required central venous catheter removal because of mechanical fracture of the tunneled cuffed catheter and its migration in the internal jugular vein. An urgent chest X-ray showed that the two free ends of the fractured tunneled cuffed catheter were located in the right atrium and right internal jugular vein. Phlebotomy of the internal jugular vein was successfully performed to retrieve the fractured tunneled cuffed catheter and the associated thrombi. In this case, phlebotomy for retrieval of the embolized catheter fragment extending into the right atrium was a safe alternative to an endovascular technique of catheter fragment retrieval. Phlebotomy preserved the integrity of the catheter fragment and its associated thrombus and was both cost-effective and safe.

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 Insertion of a 1.9F central venous catheter via the internal jugular vein in neonates

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092538
Author(s):  
Feixiang Luo ◽  
Xiaoying Cheng ◽  
Xiaofang Lou ◽  
Qin Wang ◽  
Xiaoyan Fan ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Success Rate ◽  
Internal Jugular Vein ◽  
Neonatal Intensive Care ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Seldinger Technique ◽  
Central Venous ◽  
Minimal Trauma ◽  
The Right

Objective This study aimed to develop a technique for placing a 1.9 French (F) central venous catheter in the internal jugular vein of newborns. Methods In this retrospective study, punctures were performed with a modified ultrasound-guided Seldinger technique with 57 1.9F catheters in 48 newborns. Punctures were performed in the right internal jugular vein in 43 (75.4%) patients and in the left internal jugular vein in 14 (24.6%) patients. Results We included 33 (57.9%) boys and 24 (42.1%) girls, aged a median 38 days (range, 2–135 days). The puncture success rate was 100%. Catheterization duration was a median 14 days (range, 1–70 days). Among the catheters, 94.1% were removed after completion of therapy or upon death. Fifty-three (93%) patients experienced no complication, whereas a small amount of bleeding was observed in 2 (3.5%) patients, inflammation of puncture in 1 (1.8%) patient, and occlusion in 1 (1.8%) patient. The method of placement of 1.9F catheters in the internal jugular vein of newborns had a high success rate, with minimal trauma and few complications. Conclusions Our method of placing a 1.9F central venous catheter in the internal jugular vein is suggested for level III to VI neonatal intensive care units.

scholarly journals Insertion of Central Venous Catheters through Arm Veins

1975 ◽  
Vol 3 (2) ◽  
pp. 101-104 ◽  
Author(s):  
Jean Lumley ◽  
W. J. Russell
Keyword(s):  
Central Venous Catheter ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
The Other ◽  
Central Venous ◽  
Catheter Tip ◽  
Arm Vein

The position of the tip of a central venous catheter inserted through an arm vein is not influenced by the arm or by the vein chosen. There may be some advantage in inserting the catheter with the arm at the patient's side, although there seems to be no benefit from turning the patient's head towards the side of insertion. Because the most common malposition from an apparently uneventful insertion is due to the catheter tip entering the internal jugular vein, neck compression has been established as a useful test. If the catheter tip is well into the internal jugular vein, compression on that side of the neck should cause a rise in the recorded pressure of 10 or more cm H2O. This rise should not occur on compression of the other side of the neck. We wish to emphasize that it is important to confirm radiographically the position of the catheter tip.

Iatrogenic lymphocutaneous fistula secondary to right-sided pheresis catheter placement and its percutaneous treatment: a case report

2017 ◽  
Vol 18 (4) ◽  
pp. e45-e47 ◽  
Author(s):  
Keith B. Quencer ◽  
Raj R. Ayyagari ◽  
Tamir Friedman
Keyword(s):  
Case Report ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Transplant Rejection ◽  
Venous Catheter ◽  
Percutaneous Treatment ◽  
Central Venous ◽  
Cyanoacrylate Glue ◽  
Image Guided ◽  
The Right

We present a case of an iatrogenic lymphocutaneous fistula secondary to placement of a tunneled, large bore (14.5 Fr) right-sided internal jugular vein for plasmapheresis to treat antibody-mediated kidney transplant rejection. While iatrogenic lymphatic leaks caused by neck and thoracic surgeries are well described in the literature, lymphatic leak or lymphocutaneous fistula resulting from image-guided placement of a central venous catheter through the right internal jugular vein has yet to be described. We also describe the successful percutaneous treatment of this lymphocutaneous fistula using a combination of n-butyl cyanoacrylate glue and embolization coils.

scholarly journals A Rare Central Venous Catheter Malposition in a 10-Year-Old Girl

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Ali Movafegh ◽  
Alireza Saliminia ◽  
Reza Atef-Yekta ◽  
Omid Azimaraghi
Keyword(s):  
Central Venous Catheter ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
Medical Procedure ◽  
Central Venous ◽  
Line Placement ◽  
Catheter Malposition ◽  
The Right

Central venous catheters (CVCs) are placed in operating rooms worldwide via different approaches. Like any other medical procedure, CVC placement can cause a variety of complications. We report the case of an unexpected malposition of a catheter in the right internal jugular vein, where it looped back on itself during placement and went upward into the right internal jugular vein. CVC line placement should always be viewed as a procedure that could become complicated, even in the hands of the most experienced operators.

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