CT analysis of a safe approach for translumbar access to the aorta and inferior vena cava.

Percutaneous translumbar inferior vena cava cannulation under computed tomography guidance

“…15,17 As alternative approaches to conventional cannulation, central venous catheter placement by translumbar cannulation, transhepatic cannulation, or transhepatic vein cannulation has been reported. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] When cannulating the IVC using an alternative approach, studies have reported that translumbar cannulation should be used preferentially because it is associated with fewer complications than percutaneous transhepatic cannulation. 10,18,19 Translumbar cannulation was fi rst reported by Kenney in 1985, and its use has been documented in a large number of cases with clinical results and complications in studies from the United States.…”

“…10,18,19 Translumbar cannulation was fi rst reported by Kenney in 1985, and its use has been documented in a large number of cases with clinical results and complications in studies from the United States. 1,2,[4][5][6][7][8][10][11][12][13] The situations for which translumbar IVC cannulation has been selected are as follows. 20,21 First, traditional access sites other than the femoral vein cannot be used.…”

“…According to Bennett et al, retroperitoneal hematoma was not discovered immediately after placement but was seen at 48 h after catheter placement due to fl ank pain and bruising, confi rmed by CT. 13 Cazenave et al 24 deduced a safe pathway for percutaneous translumbar IVC cannulation by CT and discussed the slope of the puncture needle under fl uoroscopic guidance. This suggests that a safe pathway can be determined under CT guidance; however, to the best of our knowledge, there have been no clinical reports on CTguided cannulation.…”

“…However, when these vascular accesses are unavailable, it is necessary to consider placing a percutaneous inferior vena cava (IVC) catheter by translumbar cannulation, transhepatic cannulation, or transhepatic vein cannulation as an alternative. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] To avoid complications during IVC cannulation, we performed percutaneous translumbar IVC cannulation under computed tomography (CT) guidance for two patients.…”

Alternative Zugangswege für Hämodialysekatheter bei Patienten mit verschlossenen peripheren venösen Zugangswegen

“…Bei einer hohen translumbalen Punktion ist insbesondere die Nierenarterie gefährdet [22]. Bei Beachtung der Richtlinien für eine sichere translumbale Punktion, die von Cazenave et al 1991 [23] publiziert wurden, lässt sich das Punktionsrisiko minimieren. Die Durchführung einer CT-Untersuchung des Abdomens vor Katheteranlage empfiehlt sich in erster Linie, um eine VCI-Thrombose auszuschließen bzw.…”