Single-incision Technique for Tunneled Central Venous Access

Contractor, Sohail; Phatak, Tej; Klyde, David; Gonzales, Sharon F.; Sadowski, Sebastian; Bhagat, Nikhil

doi:10.1016/j.jvir.2009.04.065

Cited by 10 publications

(6 citation statements)

References 10 publications

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“…Contractor et al, successfully placed 72 TDCs with the advantages of fewer procedural steps and a superior cosmetic result. [ 24 ] Figure 2 shows a patient with a TDC placed into the RIJV using a single incision technique.…”

Section: Access Options For Placement Of Tdcsmentioning

confidence: 99%

Vascular Access for Placement of Tunneled Dialysis Catheters for Hemodialysis: A Systematic Approach and Clinical Practice Algorithm

Pereira

Osiason

Salsamendi

2015

Journal of Clinical Imaging Science

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The role of interventional radiology in the overall management of patients on dialysis continues to expand. In patients with end-stage renal disease (ESRD), the use of tunneled dialysis catheters (TDCs) for hemodialysis has become an integral component of treatment plans. Unfortunately, long-term use of TDCs often leads to infections, acute occlusions, and chronic venous stenosis, depletion of the patient's conventional access routes, and prevention of their recanalization. In such situations, the progressive loss of venous access sites prompts a systematic approach to alternative sites to maximize patient survival and minimize complications. In this review, we discuss the advantages and disadvantages of each vascular access option. We illustrate the procedures with case histories and images from our own experience at a highly active dialysis and transplant center. We rank each vascular access option and classify them into tiers based on their relative degrees of effectiveness. The conventional approaches are the most preferred, followed by alternative approaches and finally the salvage approaches. It is our intent to have this review serve as a concise and informative reference for physicians managing patients who need vascular access for hemodialysis.

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Section: Access Options For Placement Of Tdcsmentioning

confidence: 99%

Vascular Access for Placement of Tunneled Dialysis Catheters for Hemodialysis: A Systematic Approach and Clinical Practice Algorithm

Pereira

Osiason

Salsamendi

2015

Journal of Clinical Imaging Science

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“…To overcome the limitations of the conventional technique, a single-incision technique through the IJV, axillary vein, and subclavian vein has been used for TIVAP placement. The advantages of the single-incision technique include elimination of a second venotomy incision, reduction of bleeding risk, shortened procedure time, fewer infections related to the neck incision, esthetic advantages, and reduction of postoperative discomfort by avoiding the requirement for a neck dressing (4)(5)(6)(7)(8)14). The limitations of the single-incision technique via IJV are limited subcutaneous tunnel length based on needle length, a potentially inaccessible IJV depending on the patient's anatomy or available needle length, and difficulty in advancing devices with a hairpin-turn shape (6).…”

Section: Discussionmentioning

confidence: 99%

“…Conventionally, placement of the TIVAP is performed through the internal jugular vein (IJV) or the subclavian vein by creating a tunnel between the venipuncture site and port pocket in the infraclavicular area. However, the conventional technique has several potential limitations associated with the creation of two incisions, such as a risk of bleeding, patient dissatisfaction associated with discomfort and esthetic disadvantages (5,6). To overcome these limitations, the single-incision technique for placing TIVAPs has been extensively tested since 2007 (4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Placement of Totally Implantable Venous Access Ports Using the Single-Incision Technique: Outcomes and Complications

Jang

Kwon

et al. 2020

Iran J Radiol

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Background: A totally implantable venous access port (TIVAP) is an essential component of care for oncology patients. Conventional placement of the TIVAP is performed through the internal jugular vein or the subclavian vein using a tunneled catheter, which involves creating two incisions. However, the conventional technique has several potential limitations. To address these limitations, a single-incision technique without a second incision or subcutaneous tunneling has been extensively tested since first being introduced by Glenn in 2007. Objectives: The purpose of this study was to evaluate the technical success, clinical outcomes, and complications of the single-incision technique for the placement of TIVAPs. Patients and Methods: Between January 2013 and June 2017, 182 TIVAPs were placed by a single-incision technique in 175 patients, including 79 men and 96 women (mean age, 62.4 years; range: 20 - 88 years). Electronic medical records were retrospectively reviewed to obtain patient data, outcomes, and complication rates. Results: A total of 40,594 catheter maintenance days (median, 221.9 days; range, 1 - 889 days) were recorded for 182 TIVAPs in 176 patients. Technical and clinical success rates were both 100%. A total of 25 complications (complication rate, 13.74%) occurred, including catheter occlusion (5.49%), catheter-related infection (5.49%), wound dehiscence (1.10%), catheter kinking (0.55%), venous thrombosis (0.55%), and extravasation during infusion (0.55%). Conclusion: The single-incision technique for TIVAP via the axillary vein was safe and efficient with high technical and clinical success rates. This new technique may be a good alternative to conventional techniques.

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“…An incision for the pocket is made over the chest wall at a different site from venous entry, and a tunnel in the subcutaneous layer connects venous entry at the infraclavicular area or neck and the pocket. Potential drawbacks of the conventional technique with a subcutaneous tunnel are incorrect measurement of catheter length, difficulty in advancing tunneling devices associated with pain, cosmetic issues related to the neck incision required to gain access to the IJV, and patient dissatisfaction with palpation of the catheter over the clavicle (9–10–11).…”

Section: Introductionmentioning

confidence: 99%

“…Implantation of the TIVAP using a single-incision technique could reduce the disadvantages associated with the conventional technique involving a subcutaneous tunnel (9–10–11). Glenn (9) reported a single-incision technique for implantation of the TIVAP by puncture of the IJV from a parasternal incision with a C-shaped curved micropuncture needle.…”

Section: Introductionmentioning

confidence: 99%

Long-term clinical outcomes of the single-incision technique for implantation of implantable venous access ports via the axillary vein

et al. 2017

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Single-incision Technique for Tunneled Central Venous Access

Cited by 10 publications

References 10 publications

Vascular Access for Placement of Tunneled Dialysis Catheters for Hemodialysis: A Systematic Approach and Clinical Practice Algorithm

Vascular Access for Placement of Tunneled Dialysis Catheters for Hemodialysis: A Systematic Approach and Clinical Practice Algorithm

Placement of Totally Implantable Venous Access Ports Using the Single-Incision Technique: Outcomes and Complications

Long-term clinical outcomes of the single-incision technique for implantation of implantable venous access ports via the axillary vein

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