Retrospective review of the development and implementation of a bedside tunneled dialysis catheter program.

Background: The decision to place a subcutaneously tunneled catheter is an infection prevention strategy for long term venous access allowing the proceduralist to access a vein and relocate the catheter exit site to a region on the body where care and maintenance can be safely performed. Subcutaneously tunneled centrally inserted dialysis catheter (ST-CIDC) placement is commonly performed in patients with renal disease and is traditionally performed with fluoroscopy in the interventional radiology suite or the operating theater. However, today's interventional radiologists and surgeons perform advanced invasive procedures that can be time-consuming resulting in delays in the scheduling of elective tunneled catheter placements.

Alternatives for exhausted dialysis access.

Hemodialysis (HD) access failure is a frequent problem encountered by vascular surgeons. As treatment of end-stage renal disease improves and patients live longer on HD, eventual exhaustion of traditional upper extremity HD access is common. Efforts to preserve and maintain these accesses are essential.

Pulmonary endarterectomy through inverted-T upper hemisternotomy.

Objective: We aimed to explore the feasibility of an inverted-T upper hemisternotomy approach for pulmonary endarterectomy (PEA) and report the results after 17 cases.

Methods: PEA was conducted through a 7-cm skin incision using an inverted-T upper hemisternotomy across the third intercostal spaces. Cardiopulmonary bypass (CPB) was established through central arterial and percutaneous femoral dual-staged venous cannulation.

Acute Renal Shutdown Following Femoral Central Venous Catheterization: Iatrogenic or Spontaneous Rupture of the Inferior Epigastric Artery.

Femoral central venous catheterization is a commonly performed procedure in the intensive care unit or ward in a hospital setting. Unfortunately, the venous catheterization procedure can cause insertion-related complications, commonly referred to as mechanical complications, which can range from being clinically insignificant to life-threatening if untreated. The femoral vein is chosen due to its low risk for complications such as bleeding, which are easy to control when the patient is on anticoagulants.

Ultrasound-Guided Venous Catheter Placement in Prone Position.

The prone position is often used for patients with adult respiratory distress syndrome and specific surgical postures. When performing venous cannulation in this position, it is important to have a structured review to introduce the available major veins and ultrasound-guided procedure. In this review, we discuss the techniques of ultrasound-guided cannulation and provide insights into various aspects, including the anatomical locations of veins, vein sizes, placement techniques, surrounding structures at risk, and reported experiences with catheter placements.

Ergonomics Risk Assessment of Musculoskeletal Disorder During Ultrasound-Guided Internal Jugular Venous Cannulation.

Background: Acutely sick patients can receive emergency intravenous access through central venous cannulation to administer fluids and medicines, perform haemodynamic monitoring and extracorporeal therapies, including plasmapheresis or haemodialysis. Using the Seldinger procedure, access is gained by percutaneous puncture, frequently guided by ultrasonography into the femoral, subclavian or internal jugular veins. This study aimed to identify ergonomic risk factors for musculoskeletal disorders (MSDs) in operators performing ultrasonography-guided internal jugular vein (IJV) cannulation at various table heights and probe orientations.

Protrieve Sheath embolic protection during venous thrombectomy: early experience in seventeen patients.

Purpose: The Protrieve Sheath (Inari Medical; Irvine, CA) is designed for embolic protection during venous thrombectomy. This report describes experience with its use.

Materials And Methods: Between November 2022 and December 2023 (13 months), seventeen patients, including nine (52.

Endovascular recanalization for filter-bearing inferior vena cava occlusion in a dialysis patient.

Central venous occlusion (CVO) or stenosis (CVS) is a common complication of long-term hemodialysis catheters. Endovascular intervention, primarily balloon angioplasty and occasionally stent placement, is the primary approach for managing CVS/CVO lesions. The presence of a filter within the inferior vena cava (IVC) lumen makes recanalization of the IVC more challenging.

Clues for diagnosing misplaced central venous catheter in the right ascending lumbar vein during right femoral venous access.

The right ascending lumbar vein is difficult to detect on anteroposterior abdominal radiographs because it overlaps with the inferior vena cava on anteroposterior radiographs. Intensive observation by medical providers may be a cue for diagnosis. However, knowledge of catheter misplacement of the right ascending lumbar vein is also necessary, because misplacement cannot be suspected without that awareness.

Central venous catheter-related thrombosis in patients with amyotrophic lateral sclerosis.

Background: Central venous catheterization may be required in patients with amyotrophic lateral sclerosis (ALS) for parenteral nutrition, antibiotic treatment, or blood sampling. Different venous access devices can be taken into consideration-centrally inserted central catheters (CICC), peripherally inserted central catheters (PICC), and femorally inserted central catheters (FICCs)-depending on the clinical conditions of the patients. Regardless of the type of access, the presence of paraplegia or tetraplegia is commonly considered a risk factor for catheter-related thrombosis (CRT).

A narrative review on tip navigation and tip location of central venous access devices in the neonate: Intracavitary ECG or real time ultrasound?

The proper location of the tip of a central venous access device plays a crucial role in minimizing the risks potentially associated with its use. Recent guidelines strongly recommend preferring real-time, intra-procedural methods of tip location since they are more accurate, more reliable and more cost-effective than post-procedural methods. Intracavitary electrocardiography and real time ultrasound can both be applied in the neonatal setting, but they offer different advantages or disadvantages depending on the type of central venous access device.

Rare Central Venous Catheter Malpositions: A Case Series.

Central venous catheters are a procedure that provides vascular access, allowing the application of various clinical treatments and the measurement of some hemodynamic values. It provides access to the internal jugular vein, subclavian vein, and, femoral vein with a large-bore catheter. There are mechanical, infectious, and thromboembolic complications resulting from central venous catheter placement and care.

Unique report of iliocaval endovascular reconstruction successfully enabling a kidney transplant.

Patients with end-stage renal disease and iliocaval venous obstruction are normally nonviable recipients of kidney transplantation. We report a case of a 34-year-old male patient who has been receiving hemodialysis as renal replacement therapy for 6 years due to immunoglobulin A nephropathy. Past medical history included multiple central venous catheter infections and catheter-associated thrombosis.

Removal of fractured peripherally inserted central venous catheter in the leg of a neonate.

An infant with a corrected gestational age of 38 weeks, weighing 3.1 kg, was referred to our pediatric surgical department because of a fractured peripherally inserted central venous catheter in the left lower limb with the end retracting into the deep venous system. An operation was undertaken to remove the PICC.

Preclose Versus Postclose Using Suture-Mediated Vascular Closure System for Catheter Ablation With Femoral Vein Access.

Background: Differences in the efficacy and safety between the preclose and postclose suture-mediated vascular closure systems for femoral vein access have not been adequately studied.

Objectives: This study aimed to evaluate the efficacy and safety of these 2 suturing techniques in femoral vein access.

Methods: Patients subjected to elective catheter ablation via the femoral vein using a sheath of 8- to 13-F inner diameter (n = 282) were randomized to the preclose or postclose groups for the single-suture technique using ProGlide/ProStyle (Abbott Vascular).

Popliteal venous access for renal replacement therapy in a critically ill patient with central access failure.

A woman in her 80s was admitted to the emergency department with an acute infective exacerbation of chronic obstructive pulmonary disease and type 2 respiratory failure, culminating in cardiac arrest for 2 min. She was successfully resuscitated, connected to a mechanical ventilator and subsequently transferred to the intensive care unit. Later in her hospital stay, the patient underwent a tracheostomy following prolonged intubation.

Proximalization of Arterial Inflow for the Treatment of Limb Ischemia in a Transposed Femoral Arteriovenous Fistula-A Case Report.

Introduction: Femoral vein transposition is one of the final resorts for vascular access in patients with exhaustion of upper limb venous patrimony and central venous occlusive disease. Its major pitfalls include hemodialysis access-induced distal ischemia and infection. Surgical procedures may be warranted to preserve vascular access if ischemia develops.

Totally implanted central venous access devices inserted by the femoral route: A narrative review and the proposal of a novel approach, the FICC-port.

Background: Femoral ports are used in patients with indication to a totally implanted venous access device but with contraindication to chest-ports and brachial ports because of obstruction of the superior vena cava. In the last three decades, femoral ports have been implanted almost exclusively by cannulation of the common femoral vein at the groin, while the position of the tip has been assessed by X-ray.

Methods: We report our experience with a new approach to femoral ports, which includes recent methods and techniques developed in the last few years.

A technique to retrieve an internalised embedded central venous catheter.

Background: Central venous catheters may become embedded due to the formation of adhesions between the indwelling catheter and the vein wall.

Case Presentation: A 49-year-old patient with bacteraemia was referred for retrieval of an embedded internalised central venous dialysis catheter. Recently the catheter had been surgically ligated at the venotomy site internalising the intravascular catheter component, which precluded antegrade ballooning through the catheter hub.

Vascular access challenges in hemodialysis patients with superior vena cava syndrome.

Background: Superior vena cava syndrome in hemodialysis patients resulting from previous or current use of a tunneled central vein catheter is a rare but potentially severe condition. Two aspects have to be addressed during management and treatment: the restoration of central venous flow and the creation of an alternative vascular access to guarantee hemodialysis.

Research Design: Conforming to the current guidelines and literature, we present a stepwise approach and discuss therapeutic options.

Placement of peripherally inserted central catheters in neonates: A retrospective study.

Background: Peripherally inserted central catheters (PICCs) are commonly used in neonatal intensive care units for extended intravenous nutrition and therapy. The selection of PICCs insertion sites can significantly influence insertion outcomes and neonatal safety.

Aim: This study aimed to determine the most suitable insertion site in the lower extremities for neonatal PICCs.