Central vein catheterization. Failure and complication rates by three percutaneous approaches

The success rate and safety of internal jugular vein cannulation using anatomical landmark technique in patients undergoing cardiothoracic surgery

“…The higher success rate in the present study when compared with the landmark technique of the studies by Troianos et al, [24] Denys et al, [25] and Turker et al, [2] is difficult to explain, but it may be due to different level of experience and the fact that in the present study, the cannulations were performed in anesthetized and mechanically ventilated patients, whereas in all the above mentioned studies, the patients were spontaneously breathing. Our results are in accordance with the study by Sznajder et al, [7] which shows higher success rate and lower complication rates by even inexperienced physicians in mechanically ventilated patients than in spontaneously breathing patients. Application of positive end expiratory pressure in mechanically ventilated patients also increases the cross sectional area of IJV and facilitates cannulation.…”

“…[19][20][21] The landmark technique has been used traditionally with a success rate of 85-95%. [6,7] It is a blind procedure primarily based on the anatomical landmarks, but an experienced operator also locates the vein by balloting it by finger. [22,23] In patients undergoing cardiac surgery, identification and cannulation of IJV is facilitated by the raised CV pressure that exists in most of these patients.…”

“…Application of positive end expiratory pressure in mechanically ventilated patients also increases the cross sectional area of IJV and facilitates cannulation. [7,15] In spontaneously breathing patients, one must take the precaution of puncturing the IJV in the expiratory phase. Karakitsos et al, [26] compared the real-time ultrasound-guided catheterization with the landmark technique in mechanically ventilated critically ill patients in intensive care unit (ICU).…”

“…The reported success rate of CV cannulation using landmark technique varies between 85% and 95% [6,7] with a complication rate of 6.3-11.8%. [8][9][10][11][12][13][14] Anomalies in the anatomy and the blind nature of the procedure may cause the operator to pass the needle in an inappropriate direction and each attempt increases the risk of complications; therefore, a successful IJV cannulation in first attempt is desirable.…”

An Unusual Cause of HD Catheter Dysfunction

“…IJV catheterization can be associated with many well-documented complications [4,5,6,7,8], but AVF between the carotid artery and IJV is rare [2,3,4]. In a minority of cases it develops from the carotid arterial puncture (CAP), and CAP is a frequent complication because of the anatomic relation of the two vessels with an incidence of 2–9.9% [9].…”