eMedicine Specialties > Radiology > Vascular/Interventional
Central Venous Access: Multimedia
Updated: May 23, 2008
Multimedia
 | Media file 1: Chest radiograph demonstrates an entire Swan catheter within the venous system with no residual catheter portion outside the patient. |
 | Media file 2: Digital image demonstrates a snare being placed over the proximal catheter fragment via the right femoral approach. |
 | Media file 3: Radiograph demonstrates a snare that is being used to pull back a catheter into the inferior vena cava (same patient as in Images 1-2 in Multimedia). |
 | Media file 4: Retrieved catheter fragment (same patient as in Images 1-3 in Multimedia). |
 | Media file 5: Abdominal radiograph demonstrates a J-wire trapped in the apex of a Greenfield filter. The wire became trapped during blind placement of a central venous line. |
 | Media file 6: Magnified image demonstrates the J-wire trapped in the apex of a Greenfield filter (same patient as in Images 5 and 7 in Multimedia). |
 | Media file 7: A catheter was advanced over the wire and used to gently remove the trapped wire from the Greenfield filter (same patient as in Images 5-6 in Multimedia). |
 | Media file 8:
The injection of contrast material through a
Hickman catheter demonstrates the presence of a fibrin sheath
at its tip (same patient as in Images 9-10 in
Multimedia). |
 | Media file 9: Magnification view of the tip of the catheter demonstrates the fibrin sheath (same patient as in Images 8 and 10 in Multimedia). |
 | Media file 10: An Amplatz snare has been used to strip off the fibrin sheath. Note the free flow of contrast material from the catheter tip (same patient as in Images 8-9 in Multimedia). |
 | Media file 11: Digital chest image demonstrates that the tip of a Hickman catheter has migrated into the right jugular vein. |
 | Media file 12: The tip of a Hickman catheter has been redirected into the superior vena cava. |
 | Media file 13: Transverse ultrasonogram of the neck demonstrates the jugular vein (Jug) next to the carotid artery (Car). |
 | Media file 14: Note the bright echogenic tip of the micropuncture needle as it enters the jugular vein (arrowhead). |
More on Central Venous Access |
| References |
References
Funaki B, Zaleski GX, Leef JA, Rosenblum JD. Radiologic placement of long-term hemodialysis catheters in occluded jugular or subclavian veins or through patent thyrocervical collateral veins. AJR Am J Roentgenol. May 1998;170(5):1194-6. [Medline].
Kidney DD, Nguyen DT, Deutsch LS. Radiologic evaluation and management of malfunctioning long-term central vein catheters. AJR Am J Roentgenol. Nov 1998;171(5):1251-7. [Medline].
Noh HM, Kaufman JA, Rhea JT, et al. Cost comparison of radiologic versus surgical placement of long-term hemodialysis catheters. AJR Am J Roentgenol. Mar 1999;172(3):673-5. [Medline].
Hartnell GG, Gates J, Suojanen JN, Clouse ME. Transfemoral repositioning of malpositioned central venous catheters. Cardiovasc Intervent Radiol. Sep-Oct 1996;19(5):329-31. [Medline].
Farrell J, Gellens M. Ultrasound-guided cannulation versus the landmark-guided technique for acute haemodialysis access. Nephrol Dial Transplant. Jun 1997;12(6):1234-7. [Medline].
Lyon SM, Given M, Marshall NL. Interventional radiology in the provision and maintenance of long-term central venous access. J Med Imaging Radiat Oncol. Feb 2008;52(1):10-7. [Medline].
Ishizuka M, Nagata H, Takagi K, Kubota K. External jugular venous catheterization with a Groshong catheter for central venous access. J Surg Oncol. May 1 2008;[Medline].
Forauer AR, Glockner JF. Importance of US findings in access planning during jugular vein hemodialysis catheter placements. J Vasc Interv Radiol. Feb 2000;11(2 Pt 1):233-8. [Medline].
Bennett JD, Papadouris D, Rankin RN, et al. Percutaneous inferior vena caval approach for long-term central venous access. J Vasc Interv Radiol. Sep-Oct 1997;8(5):851-5. [Medline].
Markowitz DG, Rosenblum DI, Newman JS, Garby KB. Translumbar inferior vena caval Tesio catheter for hemodialysis. J Vasc Interv Radiol. Jan-Feb 1998;9(1 Pt 1):145-7. [Medline].
Rajan DK, Croteau DL, Sturza SG, et al. Translumbar placement of inferior vena caval catheters: a solution for challenging hemodialysis access. Radiographics. Sep-Oct 1998;18(5):1155-67; discussion 1167-70. [Medline].
Johansson E, Engervall P, Björvell H, Hast R, Björkholm M. Patients' perceptions of having a central venous catheter or a totally implantable subcutaneous port system-results from a randomised study in acute leukaemia. Support Care Cancer. May 1 2008;[Medline].
Bergey EA, Kaye RD, Reyes J, Towbin RB. Transhepatic insertion of vascular dialysis catheters in children: a safe, life-prolonging procedure. Pediatr Radiol. Jan 1999;29(1):42-5. [Medline].
Warkentine FH, Clyde Pierce M, Lorenz D, Kim IK. The anatomic relationship of femoral vein to femoral artery in euvolemic pediatric patients by ultrasonography: implications for pediatric femoral central venous access. Acad Emerg Med. May 2008;15(5):426-30. [Medline].
Chand DH, Valentini RP, Kamil ES. Hemodialysis vascular access options in pediatrics: considerations for patients and practitioners. Pediatr Nephrol. Apr 8 2008;[Medline].
Darouiche RO, Raad II, Heard SO, et al. A comparison of two antimicrobial-impregnated central venous catheters. Catheter Study Group. N Engl J Med. Jan 7 1999;340(1):1-8. [Medline].
Gordon AC, Saliken JC, Johns D, et al. US-guided puncture of the internal jugular vein: complications and anatomic considerations. J Vasc Interv Radiol. Mar-Apr 1998;9(2):333-8. [Medline].
Chrisman HB, Omary RA, Nemcek AA, et al. Peripherally inserted central catheters: guidance with use of US versus venography in 2,650 patients. J Vasc Interv Radiol. Apr 1999;10(4):473-5. [Medline].
Davis SN, Vermeulen L, Banton J. Activity and dosage of alteplase dilution for clearing occlusions of venous-access devices. Am J Health Syst Pharm. Jun 1 2000;57(11):1039-45. [Medline].
Semba CP, Bakal CW, Calis KA, et al. Alteplase as an alternative to urokinase. Advisory Panel on Catheter- Directed Thrombolytic Therapy. J Vasc Interv Radiol. Mar 2000;11(3):279-87. [Medline].
Savader SJ, Ehrman KO, Porter DJ. Treatment of hemodialysis catheter-associated fibrin sheaths by rt-PA infusion: critical analysis of 124 procedures. J Vasc Interv Radiol. Jun 2001;12(6):711-5. [Medline].
Garofalo RS, Zaleski GX, Lorenz JM, et al. Exchange of poorly functioning tunneled permanent hemodialysis catheters. AJR Am J Roentgenol. Jul 1999;173(1):155-8. [Medline].
Xiang DZ, Verbeken EK, Van Lommel AT, et al. Composition and formation of the sleeve enveloping a central venous catheter. J Vasc Surg. Aug 1998;28(2):260-71. [Medline].
Crain MR, Mewissen MW, Ostrowski GJ, et al. Fibrin sleeve stripping for salvage of failing hemodialysis catheters: technique and initial results. Radiology. Jan 1996;198(1):41-4. [Medline].
Haskal ZJ, Leen VH, Thomas-Hawkins C, et al. Transvenous removal of fibrin sheaths from tunneled hemodialysis catheters. J Vasc Interv Radiol. Jul-Aug 1996;7(4):513-7. [Medline].
Rockall AG, Harris A, Wetton CW, et al. Stripping of failing haemodialysis catheters using the Ampltaz gooseneck snare. Clin Radiol. Aug 1997;52(8):616-20. [Medline].
Andris DA, Krzywda EA. Catheter pinch-off syndrome: recognition and management. J Intraven Nurs. Sep-Oct 1997;20(5):233-7. [Medline].
Coles CE, Whitear WP, Le Vay JH. Spontaneous fracture and embolization of a central venous catheter: prevention and early detection. Clin Oncol (R Coll Radiol). 1998;10(6):412-4. [Medline].
de Costa BR, Dickey K, Greenwood L. A practical approach for repositioning flipped venous access ports. J Vasc Interv Radiol. Feb 2000;11(2 Pt 1):213-4. [Medline].
Further Reading
Keywords
central venous access, catheters, ultrasonographic guidance in venous access, sonographic guidance in venous access, access sites, access devices, ports, catheter-related complications, catheter fracture, malpositioned catheter, catheter malpositioning, guidewires
