Tunneled Infusion Catheters: Increased Incidence of Symptomatic Venous Thrombosis after Subclavian versus Internal Jugular Venous Access

Trerotola, Scott O.; Kuhn-Fulton, Jeannette; Johnson, Matthew S.; Shah, Himanshu; Ambrosius, Walter T.; Kneebone, Patricia H.

doi:10.1148/radiology.217.1.r00oc2789

Cited by 175 publications

(105 citation statements)

References 21 publications

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“…After they have been implanted, stents may migrate, and cardiac pacemaker wires. [2][3][4] One study found that 27% of patients with COVD had a previous history of catheters or pacemaker wires, 2 primarily in subclavian veins, in which the occurrence of the disease can reach 50%, in contrast with the internal jugular vein, in which the occurrence rate is 10%. 3 This prevalence was associated with the large caliber of hemodialysis catheters and the high flow rates of dialysis sessions.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of occlusive central venous disease: one center's experience

Silvestre¹,

Trevisan²,

Sardinha³

et al. 2014

J. vasc. bras.

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Introduction: The majority of cases of stenosis or occlusion of central veins are the result of central catheters, arteriovenous fistulas, neoplasms or traumas and these conditions can cause severe cases of venous hypertension or reduce the flow through fistulas. The objective of this study is to analyze the results of central venous angioplasties conducted at our hospital. Methodology: We conducted a retrospective and descriptive study to analyze the results of central venous angioplasties conducted from 2010 to 2012 at a university hospital run by the Universidade Estadual de Londrina, Brazil. We calculated primary and secondary success rates and analyzed whether or not stents were used and complications occurred during a 6-month follow-up period. Results: A total of 25 central venous angioplasties were conducted. Twenty-four (96%) of these were because of catheter-related intimal hyperplasia and one was to treat the effects of compression by a tumor. Fifteen (60%) angioplasties were to correct stenosis and ten (40%) were because of occlusions, with a one-hundred percent success rate for all stenosis-related procedures. However, none of the cases of occlusion could be treated endovascularly. Patency during the 6-months follow-up period was 80% after reinterventions. Conclusions: Despite good results observed after primary interventions for stenoses, it must be accepted that all current treatment options for chronic occlusive venous disease will, sooner or later, lead to restenosis or occlusion. Venous occlusions constitute a challenge demanding the development of new techniques and new materials. Prevention is paramount, through avoidance of central catheterization and early creation of arteriovenous fistulas.

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Section: Discussionmentioning

confidence: 99%

Endovascular treatment of occlusive central venous disease: one center's experience

Silvestre¹,

Trevisan²,

Sardinha³

et al. 2014

J. vasc. bras.

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“…Category IA C. No recommendation can be made for a preferred site of insertion to minimize infection risk for a tunneled CVC [61][62][63]. Unresolved issue D. Place catheters used for hemodialysis and pheresis in a jugular or femoral vein rather than a subclavian vein to avoid venous stenosis if catheter access is needed [259][260][261][262][263]. Category IA IV.…”

Section: Category Ib II Surveillancementioning

confidence: 99%

Guidelines for the prevention of intravascular catheter-related infections

O’Grady¹,

Alexander²,

Dellinger³

et al. 2002

American Journal of Infection Control

636

843

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These guidelines have been developed for practitioners who insert catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home health-care settings. This report was prepared by a working group comprising members from professional organizations representing the disciplines of critical care medicine, infectious diseases, health-care infection control, surgery, anesthesiology, interventional radiology, pulmonary medicine, pediatric medicine, and nursing. The These guidelines are intended to provide evidencebased recommendations for preventing catheter-related infections. Major areas of emphasis include 1) educating and training health-care providers who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a 2% chlorhexidine preparation for skin antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (i.e., education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis). These guidelines also identify performance indicators that can be used locally by health-care institutions or organizations to monitor their success in implementing these evidence-based recommendations.

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“…Such complications occur in 11-50 % of haemodialytic patients [1][2][3][4] . The most frequently quoted causes of stenosis or occlusion of the central venous system in such patients include acute and chronic trauma caused by the repeated punctures and cannulations of the subclavian veins 2,5,6 . Other causes in patients with shunt include hypercirculation accompanied by turbulencies, aggregation of thrombocytes and occurrence of thrombi leading to intima hyperplasia and fibrosis in the location of the original stenosis 1 .…”

Section: Introductionmentioning

confidence: 99%

Endovascular treatment of central venous stenoses in patients with dialysis shunts

Buriánková¹,

Köcher²,

Bachleda³

et al. 2003

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Objective: Evaluation of long-term results of percutaneous treatment of central vein stenoses or occlusions in patients with haemodialysis shunt.Materials and Methods: In 26 patients with haemodialysis shunts and confirmed central vein stenosis or occlusion, 28 primary percutaneous transluminal angioplasties (PTA) and 5 repeated PTAs (re-PTA) were performed; in three patients a stent was implanted -primary in one patient and due to early restenosis after PTA in two patients. To maintain stent patency, 10 re-PTA were performed.Results: The technical success rate of primary interventions was 96 % (100 % in stenoses and 50 % in occlusions). Primary post-PTA patency rate was 70 % at 3 months, 60 % at 6 months and 30 % at 12 months.Conclusion: PTA with possible stent implantation is a first-choice method in the treatment of stenoses and occlusions of the central venous system. Despite the relatively frequent re-interventions, endovascular treatment is capable to preserve long-term function of the dialysis shunt.Abbreviations: a-v -arterio-venous; CVS -central venous system; PTA -percutaneous transluminal angioplasty; re-PTA -repeated PTA.

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Tunneled Infusion Catheters: Increased Incidence of Symptomatic Venous Thrombosis after Subclavian versus Internal Jugular Venous Access

Abstract: The IJV is the preferred site for tunneled infusion catheter placement because of the lower incidence of symptomatic venous thrombosis.

Cited by 175 publications

References 21 publications

Endovascular treatment of occlusive central venous disease: one center's experience

Endovascular treatment of occlusive central venous disease: one center's experience

Guidelines for the prevention of intravascular catheter-related infections

Endovascular treatment of central venous stenoses in patients with dialysis shunts

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