1
|
Kumar A, Sinha C, Kumar A, Kumari P, Singh K, Sinha AK. Comparison between in-plane and out-of-plane techniques for ultrasound guided cannulation of the left brachiocephalic vein in pediatric population: A randomised controlled trial. Anaesth Crit Care Pain Med 2023; 42:101247. [PMID: 37211216 DOI: 10.1016/j.accpm.2023.101247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/05/2023] [Accepted: 05/07/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND AND AIMS Brachiocephalic vein is a novel site for central venous cannulation in infants. It becomes useful in patients where the internal jugular vein lumen is small (e.g., volume deficient patient), patients with a history of multiple cannulations, and in whom subclavian puncture is contraindicated. METHODS In this randomized double-blinded study, 100 patients, aged between 0 and 1 year scheduled for elective central venous cannulation were recruited. The patients were allocated into two groups (50 patients in each). Group I patients had ultrasound (US) guided cannulation of the left brachiocephalic vein (BCV) by inserting a needle in-plane to the US probe from lateral to the medial direction, whereas Group II patients underwent cannulation of the BCV via an out-of-plane approach. RESULTS The first-attempt success rate was significantly higher in Group I (74%) than in Group II (36%) (p < 0.001). The total success rate was higher in group I (98%) than in group II (88%) however the difference was statistically insignificant (p > 0.05). The mean BCV cannulation time was significantly shorter in group I (35.46 ± 25.10) than in group II (65.24 ± 40.26) (p < 0.001). The rate of unsuccessful BCV cannulation (12%) and hematoma development (12%) was significantly higher in group II than in group I (2%). CONCLUSION Compared to the out-of-plane approach of left BCV cannulation, US-guided in-plane cannulation of the left BCV increased the first-attempt success rate, decreased the number of puncture attempts, and decreased the time required for cannulation.
Collapse
Affiliation(s)
- Amarjeet Kumar
- Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, India
| | - Chandni Sinha
- Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, India.
| | - Ajeet Kumar
- Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, India
| | - Poonam Kumari
- Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, India
| | - Kunal Singh
- Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, India
| | - Amit Kumar Sinha
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Patna, India
| |
Collapse
|
2
|
Farhadi E, Aslanabadi S, Badebarin D, Jamshidi M, Ladan AH, Hasanzadeh N, Rezaee M. Comparison of Open and Ultrasound-Guided Placement of Central Venous Catheter in Children Weighing Less Than Five Kilograms; A Randomized Clinical Trial. Acad Radiol 2022:S1076-6332(22)00547-5. [DOI: 10.1016/j.acra.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/25/2022] [Accepted: 10/09/2022] [Indexed: 11/27/2022]
|
3
|
Ding W, Qiu L, Li T, Su W, Yu Q, Hu T, Wang C, Fan C, Wang W. Ultrasound-guided totally implantable venous access ports placement via right brachiocephalic vein in pediatric population: A clinical debut. Pediatr Blood Cancer 2022; 69:e29911. [PMID: 35880972 DOI: 10.1002/pbc.29911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/07/2022] [Accepted: 07/14/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVES To investigate the feasibility and safety of ultrasound-guided totally implantable venous access ports (TIVAPs) via the right brachiocephalic vein (BCV) in pediatric patients. METHODS A single-institute retrospective review was performed on 35 pediatric patients with predominantly hematological malignancies (88.6%) who underwent TIVAP implantation via ultrasound-guided right BCV approach from July 2018 to June 2021. The catheter tip was adjusted to be positioned at the cavoatrial junction under pulsed fluoroscopic guidance. Technical success rate, procedural information, and TIVAP-related complications were evaluated. RESULTS All the pediatric TIVAP devices were successfully implanted via right BCV access. Venous access was successful by first attempt in 32 children (91%), two cases (5.7%) required a second attempt, and one patient (2.9%) required a third attempt. The mean procedural time was 44.6 ± 6.4 minutes (range: 34-62 minutes). No intraoperative complications occurred. The average TIVAP indwelling time was 564 ± 208 days (range: 193-1014 days), with a cumulative 19,723 catheter-days. Overall, three patients (8.6%) experienced four postoperative complications (two cases of local hematoma and two catheter dysfunctions) at a rate of 0.2 per 1000 catheter-days. No other complications such as wound dehiscence, delayed incision healing, catheter-related thrombosis (CRT), catheter malposition/fracture, surgical site infection, catheter-related bloodstream infection (CRBSI), pinch-off syndrome, and drug extravasation were observed during follow-up. CONCLUSIONS Ultrasound-guided right BCV access for TIVAP placement in pediatric patients appears to be technically feasible, safe, and effective. Further large-sample, prospective studies are warranted.
Collapse
Affiliation(s)
- Wei Ding
- Department of Interventional Radiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
| | - Lu Qiu
- Department of Radiology, The Affiliated Wuxi Children's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
| | - Tianyu Li
- Department of Hematology and Oncology, The Affiliated Wuxi Children's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
| | - Weiwei Su
- Department of Cardiology, The Affiliated Wuxi Children's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
| | - Qian Yu
- Division of Interventional Radiology, Department of Radiology, Medical Center, University of Chicago, Chicago, Illinois, USA
| | - Tianshen Hu
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Chunxin Wang
- Department of Radiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
| | - Chen Fan
- Department of Interventional Radiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
| | - Weidong Wang
- Department of Interventional Radiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
| |
Collapse
|
4
|
Trabelsi B, Hajjej Z, Drira D, Yedes A, Labbene I, Ferjani M, Ben Ali M. Comparison of ultrasound-guided internal jugular vein and supraclavicular subclavian vein catheterization in critically ill patients: a prospective, randomized clinical trial. Ann Intensive Care 2022; 12:91. [PMID: 36183049 PMCID: PMC9526766 DOI: 10.1186/s13613-022-01065-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Background The aim of this study was to compare the effectiveness and safety of ultrasound-guided out-of-plane internal jugular vein (OOP-IJV) and in-plane supraclavicular subclavian vein (IP-SSCV) catheterization in adult intensive care unit. Methods A total of 250 consecutive patients requiring central venous catheterization, were randomly assigned to undergo either ultrasound-guided OOP-IJV or IP-SSCV cannulation. All catheterizations were carried out by three physicians. The primary outcome was the first attempt success rate. Ultrasound scanning time, venous puncture time, insertion time, overall access time, number of puncture attempts, number of needle redirections, success rate, guidewire advancing difficulties, venous collapse and adverse events were also documented. Results The first attempt success rate was significantly higher in IP-SSCV group (83.2%) compared to OOP-IJV group (63.2%) (p = 0.001). The IP-SSCV group was associated with a longer ultrasound scanning time (16.54 ± 13.51 vs. 5.26 ± 4.05 s; p < 0.001) and a shorter insertion time (43.98 ± 26.77 vs. 53.12 ± 40.21 s; p = 0.038). In the IP-SCCV group, we recorded a fewer number of puncture attempts (1.16 ± 0.39 vs. 1.47 ± 0.71; p < 0.001), needle redirections (0.69 ± 0.58 vs. 1.17 ± 0.95; p < 0.001), difficulties in guidewire advancement (2.4% vs. 27.4%; p < 0.001), venous collapse (2.4%, vs. 18.4%; p < 0.001) and adverse events (8.8% vs. 13.6%; p = 0.22). Conclusions The IP-SSCV approach is an effective and a safe alternative to the classic OOP-IJV catheterization in critical adult patients. Trial registration: Clinicaltrials.gov, NCT03879954. Registered March 19, 2019—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03879954. Supplementary Information The online version contains supplementary material available at 10.1186/s13613-022-01065-x.
Collapse
Affiliation(s)
- Becem Trabelsi
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine of Tunis, Taher Maamouri Teaching Hospital of Nabeul, University of Tunis El Manar, 8000, Nabeul, Tunisia.
| | - Zied Hajjej
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine of Tunis, Military Hospital of Tunis, University of Tunis El Manar, 1008 Montfleury, LR12DN01, Tunis, Tunisia
| | - Dhouha Drira
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine of Tunis, Taher Maamouri Teaching Hospital of Nabeul, University of Tunis El Manar, 8000, Nabeul, Tunisia
| | - Azza Yedes
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine of Tunis, Taher Maamouri Teaching Hospital of Nabeul, University of Tunis El Manar, 8000, Nabeul, Tunisia
| | - Iheb Labbene
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine of Tunis, Military Hospital of Tunis, University of Tunis El Manar, 1008 Montfleury, LR12DN01, Tunis, Tunisia
| | - Mustapha Ferjani
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine of Tunis, Military Hospital of Tunis, University of Tunis El Manar, 1008 Montfleury, LR12DN01, Tunis, Tunisia
| | - Mechaal Ben Ali
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine of Tunis, Taher Maamouri Teaching Hospital of Nabeul, University of Tunis El Manar, 8000, Nabeul, Tunisia
| |
Collapse
|
5
|
Aydın T, Balaban O, Turgut M, Tokur ME, Musmul A. A Novel Method for Ultrasound-Guided Central Catheter Placement-Supraclavicular Brachiocephalic Vein Catheterization Versus Jugular Catheterization: A Prospective Randomized Study. J Cardiothorac Vasc Anesth 2021; 36:998-1006. [PMID: 34247928 DOI: 10.1053/j.jvca.2021.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To assess the superiority of a novel ultrasound-guided central venous catheterization technique, supraclavicular brachiocephalic catheterization, compared to jugular vein catheterization. DESIGN Prospective randomized trial. SETTING Operating rooms and intensive care unit. PARTICIPANTS Eighty-six patients with central catheter placement were included in the present study. INTERVENTIONS In the brachiocephalic group, ultrasound-guided catheterization of the brachiocephalic vein was performed via the supraclavicular route using needle-in-plane and syringe-free techniques. In the jugular group, ultrasound-guided catheterization of the internal jugular vein was performed using the needle-out-of-plane technique. MEASUREMENTS AND MAIN RESULTS Measurements included number of needle insertion attempts, ultrasonography times, and cannulation times. Additionally, ultrasound visibility of the veins, needle, guidewire, and catheter, as well as ease of the procedure, were assessed. Mean cannulation time was 27.65 ± 25.36 seconds in Group B and 28.16 ± 21.72 seconds in Group J. The overall success rate was 97.6% in Group B and 97.7% in Group J. The mean ease score of the cannulation procedure was 8.78 ± 1.13 in Group B and 8.67 ± 1.23 in Group J. No significant differences were detected between groups. The mean ultrasonography time was 11.98 ± 6.91 seconds in Group B and 2.88 ± 1.47 seconds in Group J. Ultrasound visibility of the brachiocephalic, jugular, and subclavian veins, as well as the needle and the guidewire, were good; however, visibility of the catheter was poor. CONCLUSIONS Although not superior to the standard internal jugular approach, the novel supraclavicular approach proved to be a noninferior method for central venous cannulation.
Collapse
Affiliation(s)
- Tayfun Aydın
- Kutahya Health Sciences University Hospital, Department of Anesthesiology and Reanimation, Kutahya, Turkey
| | - Onur Balaban
- Sakarya University Hospital, Department of Anesthesiology and Reanimation, Sakarya, Turkey.
| | - Miray Turgut
- Kutahya Health Sciences University Hospital, Department of Anesthesiology and Reanimation, Kutahya, Turkey
| | - Murat Emre Tokur
- Kutahya Health Sciences University Hospital, Department of Anesthesiology and Reanimation, Kutahya, Turkey
| | - Ahmet Musmul
- Department of Medical Services and Techniques, Eskisehir Osmangazi University Vocational School of Health Services, Eskisehir, Turkey
| |
Collapse
|
6
|
Sun X, Bai X, Shen J, Yu Z, Zhuang Z, Jin Y. Comparison between ultrasound-guided TIVAD via the right innominate vein and the right internal jugular vein approach. BMC Surg 2019; 19:189. [PMID: 31829196 PMCID: PMC6907195 DOI: 10.1186/s12893-019-0651-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/21/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND To compare the efficacy and safety of right internal jugular vein (IJV) approach and right innominate vein (INV) approach for US-guided totally implantable venous access devices (TIVADs), and to explore the advantages and disadvantages of the two approaches. METHODS Six hundred and nineteen adult patients had long-term infusion and chemotherapy needs and inconvenience of peripheral venous infusion. Right INV approach was used to implant 339 cases of TIVADs, and right IJV approach was used to implant 280 cases of TIVADs. The success rate of one-time catheterization and the incidence of complications in the two groups were retrospectively analyzed. RESULTS All patients were successfully implanted in TIVAD. The success rates of one-time puncture in INV group and IJV approach group were 98.53% (334/339) and 95.36% (267/280), respectively. There was significant difference between the two groups (P = 0.020). The incidence of perioperative complications and long-term complications in the right INV group were 1.18% (4/339) and 3.54% (12/339), respectively, while those in the right IJV group were 1.43% (4280) and 3.93% (11280). There was no significant difference in the incidence of perioperative or long-term complications between the two groups (P = 0.785, P = 0.799, respectively). CONCLUSIONS US-guided TIVADs via the right INV approach and the right IJV approach are both safe and reliable. The right INV approach improves the one-time puncture success rate, as long as the technique is properly operated, serious complications rarely occur.
Collapse
Affiliation(s)
- Xingwei Sun
- Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, 215004 Jiangsu China
| | - Xuming Bai
- Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, 215004 Jiangsu China
| | - Jiaofeng Shen
- Department of Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, 215004 Jiangsu China
| | - Ziyang Yu
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, 215004 Jiangsu China
| | - Zhixiang Zhuang
- Department of Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, 215004 Jiangsu China
| | - Yong Jin
- Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, 215004 Jiangsu China
| |
Collapse
|
7
|
Xu L, Qin W, Zheng W, Sun X. Ultrasound-guided totally implantable venous access ports via the right innominate vein: a new approach for patients with breast cancer. World J Surg Oncol 2019; 17:196. [PMID: 31767003 PMCID: PMC6878705 DOI: 10.1186/s12957-019-1727-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/15/2019] [Indexed: 12/26/2022] Open
Abstract
Background To evaluate the feasibility and safety of ultrasound-guided totally implantable venous access port (TIVAP) implantation via the right innominate vein in patients with breast cancer. Methods Sixty-seven breast cancer patients underwent ultrasound-guided implantation of TIVAPs via the right innominate vein for administration of chemotherapy. Clinical data including technical success, success rate for the first attempt, periprocedural, and postoperative complications were recorded and retrospectively studied. Results All patients underwent successful surgery. The success rate of the first attempt was 95.52% (64/67). The operation time was 28 to 45 min, with an average of 36 ± 6 min. Periprocedural complications included artery punctures in 1 (1.50%, 1/67) patient. Prior to this study, the mean TIVAP time was 257 ± 3 days (range 41 to 705 days). The rate of postoperative complications was 4.48% (3/67), including catheter-related infections in 1 case and fibrin sheath formation in 2 cases. Up to the present study, three people had unplanned port withdrawal due to complications, and the TIVAPs for 25 patients were still in normal use. Conclusions The success rate of ultrasound-guided TIVAPs via the right innominate vein is high with low complications, thus safe and feasible. This technique can provide a new option for chemotherapy of breast cancer patients.
Collapse
Affiliation(s)
- Liang Xu
- Department of General Surgery, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, 215500, Jiangsu, China
| | - Wenming Qin
- Department of Pain, Bazhong Central Hospital, Bazhong, 636000, Sichuan, China
| | - Weiwei Zheng
- Department of Orthopaedics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, 215004, Jiangsu, China.
| | - Xingwei Sun
- Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu, China.
| |
Collapse
|
8
|
Sun X, Bai X, Cheng L, Gu X, Xia R, Du X, Shi J, Chen Q, Jin Y. Comparison of Ultrasound-Guided Right Brachiocephalic and Right Subclavian Vein Cannulation in Adult Patients. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:2559-2564. [PMID: 30693547 DOI: 10.1002/jum.14947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 01/02/2019] [Accepted: 01/04/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To compare ultrasound-guided right brachiocephalic vein (BCV) central venous catheter (CVC) placement to right subclavian vein (SCV) CVC insertion in terms of the puncture success rate and complications. METHODS A retrospective review was performed for all adult patients who received an ultrasound-guided CVC via the right BCV or right SCV access route between January 2016 and March 2018. The puncture success rates and procedure-related complications were analyzed. RESULTS Data were analyzed from 755 adult patients who underwent 915 CVC insertions. The overall success rate was higher in the BCV group compared to that in the SCV group (98.99% versus 96.87%; P = .019). The first-attempt success rate was higher in the BCV group compared to that in the SCV group (96.64% versus 89.34%; P < .001). Intraoperative complications were observed in 16 cases in the BCV group (2.68%) and in 12 cases in the SCV group (3.76%). The incidence rates of postprocedure complications were 5.20% in the BCV group and 6.58% in the SCV group and included catheter-related infections and thrombosis. CONCLUSIONS Ultrasound-guided cannulation of the right BCV is an effective and safe method for CVC placement in adult patients and provides an additional option for catheter access.
Collapse
Affiliation(s)
- Xingwei Sun
- Department of Intervention, Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xuming Bai
- Department of Intervention, Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Long Cheng
- Department of Intervention, Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xingshi Gu
- Department of Intervention, Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Rui Xia
- Department of Oncology, Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaolong Du
- Vascular Surgery, Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jianming Shi
- Department of Oncology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Qian Chen
- Department of Oncology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Yong Jin
- Department of Intervention, Second Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
9
|
Kumar A, Sinha C, Kumar A, Kumar N, Singh JK. Ultrasound-guided left brachiocephalic vein cannulation: Where to puncture the vein? Indian J Anaesth 2019; 63:327-328. [PMID: 31000905 PMCID: PMC6460984 DOI: 10.4103/ija.ija_801_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Amarjeet Kumar
- Department of Anaesthesia, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Chandni Sinha
- Department of Anaesthesia, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Ajeet Kumar
- Department of Anaesthesia, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Neeraj Kumar
- Department of Anaesthesia, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Jitendra K Singh
- Department of Anaesthesia, All India Institute of Medical Sciences, Patna, Bihar, India
| |
Collapse
|
10
|
Sun X, Zhang Y, Yang C, Zhou Y, Bai X, Zheng W, Jin Y. Ultrasound-guided totally implantable venous access device through the right innominate vein in older patients is safe and reliable. Geriatr Gerontol Int 2019; 19:218-221. [PMID: 30724007 DOI: 10.1111/ggi.13611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/15/2018] [Accepted: 11/30/2018] [Indexed: 11/26/2022]
Abstract
AIM Ultrasound guidance has become the routine method for catheterization, dramatically reducing failure and complication rates for totally implantable venous access devices (TIVAD) placement. The aim of the present study was to report the safety and efficacy of ultrasound-guided right innominate vein TIVAD placement in older patients. METHODS Between September 2015 and September 2017, 55 older patients underwent right innominate vein TIVAD placement under ultrasound guidance. Intraoperative fluoroscopy was always carried out. The technical success rate and complications were recorded and retrospectively analyzed. RESULTS The technical success rate was 100%. The success rate of the first puncture was 96.36% (53/55). The mean operation time was 28 ± 7 min (range 23-39 min), and the mean length of catheter introduction was 19.24 ± 2.65 cm (range 17-21 cm). The overall incidence of complications was 7.27% (4/55), including one arterial puncture with self-limiting hematoma, two cases of catheter-related infection and one case of fibrin sheath. No catheter malposition or catheter fracture was observed. At the time of this study, three TIVAD were pulled out unexpectedly, and 32 TIVAD are still in functional use. CONCLUSIONS Ultrasound-guided puncture of the right innominate vein is safe and reliable to implant TIVAD, which can provide new options for older patients. Geriatr Gerontol Int 2019; 19: 218-221.
Collapse
Affiliation(s)
- Xingwei Sun
- Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yu Zhang
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Chuanlai Yang
- Department of Science and Education, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yubin Zhou
- Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xuming Bai
- Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Weiwei Zheng
- Department of Orthopedics, Suzhou Hospital affiliated to Nanjing Medical University, Suzhou, China
| | - Yong Jin
- Department of Intervention, The Second Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
11
|
Gharibvand M, Motamedfar A, Jalil A. Comparison of central venous catheter in brachiocephalic vein and internal jugular vein for the incidence of complications in patients undergoing radiology. J Family Med Prim Care 2019; 8:3379-3382. [PMID: 31742172 PMCID: PMC6857370 DOI: 10.4103/jfmpc.jfmpc_205_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 03/26/2019] [Indexed: 12/02/2022] Open
Abstract
Introduction: Central venous catheter (CVC) is an essential part of modern medical care that delivers the drugs, intravenous fluids, and intravenous feeding to the vein. So far, limited studies have been carried out on the brachiocephalic vein (BCV) in adults. This study aimed to compare the CVC in the internal jugular vein (IJV) and BCV in order to ease of access and incidence of complication such as infectious and mechanical complications. Materials and Methods: This clinical trial was performed on 52 patients who underwent BCV and the IJV catheterization. The patients were compared in two groups of IJV and BCV in order to facilitate catheterization and measure the success rate and catheterization-induced complications. The difference between the two groups was analyzed by Independent t-test and Chi-square tests. Results: Overall, 52 patients underwent intravenous catheterization. The success rate of catheterization in the first attempt was 100%. The problems of catheterization procedure in the IJV group (11.5%) were greater than the BCV group (6.6%). There was no significant difference between the two groups regarding the duration of catheterization, pneumothorax, emphysema, hematoma, arterial puncture, infection, and complete thrombosis, whereas the partial thrombosis in the IJV group (30.76%) was significantly (P < 0.05) greater than the BCV group (23.07%). Conclusion: Catheterization in both brachiocephalic and the IJV is an appropriate, highly efficient, stable, and safe procedure and ultrasound-guided catheterization is very reliable and safe method.
Collapse
|
12
|
Xia R, Sun X, Bai X, Zhou Y, Shi J, Jin Y, Chen Q. Efficacy and safety of ultrasound-guided cannulation via the right brachiocephalic vein in adult patients. Medicine (Baltimore) 2018; 97:e13661. [PMID: 30558066 PMCID: PMC6320174 DOI: 10.1097/md.0000000000013661] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 11/19/2018] [Indexed: 11/25/2022] Open
Abstract
Central venous catheter (CVC) insertion is difficult to perform and is a high-risk operation; ultrasound (US)-guided cannulation helps increase the odds of success while reducing the associated complications. The internal jugular vein (IJV) and subclavian vein (SCV) are the most commonly sites in US-guided CVC insertion. In the present study, we evaluated the safety and efficacy of US-guided supraclavicular right brachiocephalic vein (BCV) cannulations in adult patients.Between January 2016 and December 2017, 428 adult patients requiring 536 CVC insertions underwent ultrasound-guided right BCV cannulation. The success rate and complications related to indwelling catheters were analyzed.The technical success rate was 98.32% (527/536). The procedure was successful at the first try in 511 cases (95.34%). The mean operation time was 13.26 ± 3.34 minutes. The mean length of catheter introduction was 13.57 ± 3.53 cm. Incidence of intraoperative complications was 2.61%. For 3 patients, the procedure was terminated due to pneumothorax (PNX), and in 11 arterial punctures there were self-limiting hematomas. The incidence of postprocedure complications was 5.97% (32/536). These complications included catheter-related infections (n = 18) and thromboses (n = 14). Insertion lasted an average of 10.68 ± 8.77 days.Supraclavicular, in-plane, US-guided cannulation of the right BCV is an effective and safe method for inserting central venous catheters in adult patients. It provides another option for catheter access to boost clinical performance in central venous catheterization.
Collapse
Affiliation(s)
- Rui Xia
- Department of Oncology
- Department of Intervention, The Second Affiliated Hospital of Soochow University
| | - Xingwei Sun
- Department of Intervention, The Second Affiliated Hospital of Soochow University
| | - Xuming Bai
- Department of Intervention, The Second Affiliated Hospital of Soochow University
| | - Yubin Zhou
- Department of Intervention, The Second Affiliated Hospital of Soochow University
| | - Jianming Shi
- Department of Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, PR China
| | - Yong Jin
- Department of Intervention, The Second Affiliated Hospital of Soochow University
| | - Qian Chen
- Department of Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, PR China
| |
Collapse
|
13
|
Efficacy and safety of ultrasound-guided totally implantable venous access ports via the right innominate vein in adult patients with cancer: Single-centre experience and protocol. Eur J Surg Oncol 2018; 45:275-278. [PMID: 30087070 DOI: 10.1016/j.ejso.2018.07.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 06/11/2018] [Accepted: 07/18/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Totally implantable venous access ports (TIVAPs) are widely used and are an essential tool in the efficient delivery of chemotherapy. This study aimed to evaluate the feasibility and safety of implantation of ultrasound (US)-guided TIVAPs via the right innominate vein (INV) for adult patients with cancer. METHODS This study retrospectively reviewed the medical records of 283 adult patients with cancer who underwent US-guided INV puncture for TIVAPs between September 2015 and September 2017. It also analysed the technical success rate, operation time, and short-term and long-term surgical complications. RESULTS Technical success was achieved in all patients (100%). The mean operation time was 28.31 ± 7.31 min (range: 23-39 min), and the puncture success rate for the first attempt was 99.30% (281/283). Minor complications included artery puncture during the operation in one patient, but no pneumothorax was encountered. The mean TIVAP time was 304.16 ± 42.54 days (range: 38-502 days). The rate of postoperative complications was 2.83% (8/283), including poor healing of the incision in one patient, catheter-related infections in three patients, port thrombosis in one patient, and fibrin sheath formation in three patients; no catheter malposition, pinch-off syndrome, catheter fracture, or other serious complications were observed. CONCLUSIONS TIVAPs are widely employed for chemotherapy. The present study found that the novel approach of using US-guided INV puncture to implant TIVAPs in adult patients with cancer is both short-termly feasible and safe for long-term central venous access.
Collapse
|
14
|
Abstract
PURPOSE Central catheter placement is one of the most commonly performed procedures by pediatric surgeons. Here, we present a case series of patients where central access was obtained at our institution with the utilization of a novel ultrasound-guided technique. This series represents the first of its kind where the native, parent vessels were inaccessible, resulting in a challenging situation for providers. METHODS A retrospective chart review was performed in pediatric patients (0-17 years) at a tertiary care institution between July 2012 and November 2017 on all central line procedures where ultrasound was utilized to cannulate the brachiocephalic or superior vena cava in face of proximal occlusion. Our group has previous experience utilizing an image-guided in-plane approach to central line placement in the pediatric population. Demographics, operative characteristics, and postoperative complications were reviewed. RESULTS A total of 11 procedures were included in this case series where the BC (N = 9) or SVC (N = 2) were cannulated for access. Internal jugular vein cannulation was attempted on each patient unless preoperative imaging demonstrated occlusion. The median operative time was 43 ± 23 min. Most procedures were performed on the right sided (63%), with catheters ranging from 4.2F single lumen to 14F double lumen. Since being placed, three (27%) catheters have been removed, with one due to non-use, one due to sepsis, and the final one due to malposition. CONCLUSION With the continued need for long-term central access in the pediatric population, distal vein occlusion or inaccessibility can prove challenging when attempting to obtain central access. Here, demonstrated a safe alternative technique that provides an additional option in the pediatric surgeon's armamentarium for patients with difficult central access.
Collapse
|
15
|
Saasouh W, Turan A. Ultrasound a Game Changer. Turk J Anaesthesiol Reanim 2017; 45:127-128. [PMID: 28752001 DOI: 10.5152/tjar.2017.210502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 05/23/2017] [Indexed: 11/22/2022] Open
Affiliation(s)
- Wael Saasouh
- Departments of Outcomes Research and General Anesthesiology, Cleveland Clinic, Cleveland, OH, USA
| | - Alparslan Turan
- Departments of Outcomes Research and General Anesthesiology, Cleveland Clinic, Cleveland, OH, USA
| |
Collapse
|