Iatrogenic Percutaneous Vascular Injuries: Clinical Presentation, Imaging, and Management

Ge, Benjamin H.; Copelan, Alexander; Scola, Dominic; Watts, Micah M.

doi:10.1055/s-0035-1549375

Cited by 35 publications

(14 citation statements)

References 103 publications

(110 reference statements)

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“…The external iliac artery is relatively large and very close to the external iliac vein, and this may lead to arterial puncture during venous cannulation with subsequent bleeding in the form of simple hematoma up to internal bleeding [ 19 ]. The procedure was guided by ultrasound for more accurate localization of the iliac vein and to locate the catheter tip at the junction between inferior vena cava and right atrium.…”

Section: Discussionmentioning

confidence: 99%

Challenging, Safe, and Effective Use of External Iliac Vein for Insertion of Tunneled Cuffed Hemodialysis Catheters: A Single-Center Prospective Study

El-Hameed

Abdelhamid

2022

International Journal of Nephrology

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Background. Providing well-functioning vascular access is crucial for patients undergoing chronic hemodialysis. Peripheral arteriovenous fistulas and grafts are the preferred accesses in hemodialysis patients. Patients with bilateral obstruction of internal jugular veins and subclavian veins require a suitable vascular access. Thus, the insertion of iliac vein tunneled cuffed catheters (TCCs) by interventional nephrologists may be a good option for these patients. We aimed to evaluate the outcomes of iliac vein TCCs in patients lacking other vascular options. Methods. 80 tunneled cuffed hemodialysis catheters were inserted through the iliac veins of 80 patients with an end-stage kidney disease. Catheter insertion was guided by Doppler ultrasonography followed by plain radiography to detect the catheter tip and exclude complications. Results. The insertion success rate was 100%. 25 patients developed catheter-related infections. The mean survival time per catheter was 328 days. At the end of the study, 40 catheters were still functioning, 15 patients were shifted to continuous ambulatory peritoneal dialysis and 5 patients were referred to the interventional radiology department for insertion of transhepatic inferior vena cava tunneled catheters. Resistant catheter-related infection was the main cause of catheter removal in 11 patients (17.5%) in this study. Catheter malfunction was the second most common cause of catheter removal in 9 patients (11.25%). Conclusion. This study concluded that iliac vein TCCs can provide suitable vascular access in hemodialysis patients with bilateral obstruction of internal jugular veins and subclavian veins.

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Section: Discussionmentioning

confidence: 99%

Challenging, Safe, and Effective Use of External Iliac Vein for Insertion of Tunneled Cuffed Hemodialysis Catheters: A Single-Center Prospective Study

El-Hameed

Abdelhamid

2022

International Journal of Nephrology

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“…Ilio-femoral venous wounds are rare but represent a major and life-threatening condition that requires urgent management due to massive blood loss. These lesions are mostly reported in the setting of penetrating or blunt trauma (pelvic fractures) ( 1 , 2 ) but can also occur during venous line placement within kinked vessels ( 3 ). Although open surgery is the preferred treatment option, endovascular therapy might be proposed in selected cases.…”

Section: Discussionmentioning

confidence: 99%

Covered Stent Implantation for Treatment of Iliac Vein Rupture During Percutaneous Left Atrial Appendage Occlusion

et al. 2020

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“…According to a recent cross-section study of a total number of 10646 prevalent hemodialysis patients in Henan (a province in central China), tunneled catheters and non-tunneled catheters were used as vascular access for hemodialysis respectively in 1865(17.5%) and 565 (5.3%) patients. However, due to long time catheter indwell or repeated catheterization, IJV occlusion or stenosis develops and results in failure of IJV attempts or catheter dysfunction[ 17 , 18 ]. In fact, most of TDCs (583/637, 91.5%) were inserted to patients with a history of at least one time of right IJV placement in our center from January 1, 2013 to December 31, 2014.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Study of Preferable Alternative Route to Right Internal Jugular Vein for Placing Tunneled Dialysis Catheters: Right External Jugular Vein versus Left Internal Jugular Vein

Wang

Qiao

et al. 2016

PLoS ONE

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BackgroundRight internal jugular vein (IJV) is a preferred access route for tunneled (cuffed) dialysis catheters (TDCs), and both right external jugular vein (EJV) and left IJV are alternative routes for patients in case the right IJV isn’t available for TDC placement. This retrospective study aimed to determine if a disparity exists between the two alternative routes in hemodialysis patients in terms of outcomes of TDCs.Methods49 hemodialysis patients who required TDCs through right EJV (n = 21) or left IJV (n = 28) as long-term vascular access were included in this study. The primary end point was cumulative catheter patency. Secondary end points include primary catheter patency, proportion of patients that never required urokinase and incidence of catheter-related bloodstream infections (CRBSI).ResultsA total of 20,870 catheter-days were evaluated and the median was 384 (interquartile range, 262–605) catheter-days. Fewer catheters were removed in the right EJV group than in the left IJV group (P = 0.007). Mean cumulative catheter patency was higher in the right EJV group compared with the left IJV group (P = 0.031). There was no significant difference between the two groups in the incidence of CRBSI, primary catheter patency or proportion of patients that never required urokinase use. Total indwell time of antecedent catheters was identified as an independent risk factor for cumulative catheter patency by Cox regression hazards test with an HR of 2.212 (95% CI, 1.363–3.588; p = 0.001).ConclusionsRight EJV might be superior to left IJV as an alternative insertion route for TDC placement in hemodialysis patients whose right IJVs are unavailable.

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Iatrogenic Percutaneous Vascular Injuries: Clinical Presentation, Imaging, and Management

Cited by 35 publications

References 103 publications

Challenging, Safe, and Effective Use of External Iliac Vein for Insertion of Tunneled Cuffed Hemodialysis Catheters: A Single-Center Prospective Study

Challenging, Safe, and Effective Use of External Iliac Vein for Insertion of Tunneled Cuffed Hemodialysis Catheters: A Single-Center Prospective Study

Covered Stent Implantation for Treatment of Iliac Vein Rupture During Percutaneous Left Atrial Appendage Occlusion

A Retrospective Study of Preferable Alternative Route to Right Internal Jugular Vein for Placing Tunneled Dialysis Catheters: Right External Jugular Vein versus Left Internal Jugular Vein

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