The Cobweb Sign: Percutaneous Silastic Long Line Tip Placement in Tributaries of Superficial Veins

Aladangady, Narendra; Roy, Rahul; Costeloe, Kate

doi:10.1038/sj.jp.7211355

Cited by 5 publications

(3 citation statements)

References 6 publications

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“…This complication is very common in clinical practice. If the catheter is difficult to thread or to insert to the premeasured depth, blood withdrawal is difficult, the catheter flushes with resistance or removal of the stylet is difficult, this is an indication that malpositioning may have occurred (9). An X-ray examination following PICC insertion is necessary to identify whether the catheter is misplaced.…”

Section: Discussionmentioning

confidence: 99%

Malposition of peripherally inserted central catheter: Experience from 3,012 patients with cancer

Song

2013

Experimental and Therapeutic Medicine

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The aim of this study was to observe and analyze the causes of misplacement of peripherally inserted central catheters (PICCs) in patients with cancer. A total of 3,012 patients who underwent insertion of a PICC were reviewed from August 2000 to March 2012. The locations of the tube tips were recorded by chest X-ray examination. Malposition of the PICC was observed in 237 cases (7.87%), with the most frequently occurring site of misplacement being the jugular vein, followed by the axillary vein. By taking different remedies, all the malpositioned PICCs were relocated back to the superior vena cava or subclavian vein. In order to ensure the safe usage of PICCs, strict placement guidelines, skilled and experienced healthcare professionals and the cooperation of the patient is necessary.

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Section: Discussionmentioning

confidence: 99%

Malposition of peripherally inserted central catheter: Experience from 3,012 patients with cancer

Song

2013

Experimental and Therapeutic Medicine

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“…Some signs might indicate suspicious malposition, which include: (i) the catheter is difficult to thread; (ii) the catheter is difficult to reach the premeasured depth; (iii) blood withdrawal is difficult; (iv) the catheter flushes with resistance; and (v) it is difficult to remove the stylet. An X ray after PICC is necessary to idendify whether or not the catheter is malpositioned.…”

Section: Discussionmentioning

confidence: 99%

Malposition of peripherally inserted central catheter: Experience from 3012 cancer patients

Song

Guo

et al. 2013

Int J of Nursing Practice

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The objectives of the study are to observe and analyze the causes of 237 patients' malposition peripherally inserted central catheter (PICC) from 3012 patients in clinical practice and to further explore the methods of its prevention and remedies, which can help to improve the skills of placing tubes, to efficiently avoid and reduce the occurrence of complications, and to alleviate the pains and cost of patients. From August 2000 to March 2012, 3012 cases receiving PICC were reviewed. The locations of the tube tips were recorded by chest X ray and summarized for analysis. Malposition was observed in 237 cases (7.87%). The most frequently occurring site was in the jugular vein followed by the axillary vein. By taking different remedies, all the malpositioned PICCs were relocated in the superior vena cava or subclavian vein. In order to secure the safety usage of PICC, the strict rules of handling, the skill and experience of operator, and cooperation patients are necessary.

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“…23 Difficulty advancing the catheter during insertion, inadequate blood draw, and difficulties removing the stylet/dilator sheath are indicative that the catheter may have been incorrectly placed and in such cases radiography or fluoroscopy is indispensable to identify whether the catheter has been incorrectly placed. 24 In a study with 3,012 patients, conducted by Song and Li, 23 technical success was achieved in 94.6% of PICC placements and 237 devices were identified as incorrectly placed outside of the vena cava, assessed by radiography after insertion of the catheter, with the most frequent location being the jugular vein, followed by the axillary and brachial veins (Figure 7). At our service, following a preestablished protocol, we did not detect any incorrectly positioned catheters.…”

Section: Discussionmentioning

confidence: 99%

Cateteres venosos centrais de inserção periférica: alternativa ou primeira escolha em acesso vascular?

et al. 2017

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Background: Peripherally inserted central catheters (PICC) are intravenous devices inserted through a superficial or deep vein of an upper or lower extremity and advanced to the distal third of the superior vena cava or proximal third of the inferior vena cava. They offer the advantages of greater safety for infusion of vesicant/irritant and hyperosmolar solutions and enable administration of antibiotics, prolonged parenteral nutrition (PPN), and chemotherapy agents. They also involve reduced risk of infection compared to other vascular catheters and are more cost-effective than centrally inserted venous catheters (CICVC). Objectives: To present the results of our team' s experience with US-guided and fluoroscopy-positioned PICC placement at the Hospital and Maternidade São Luiz (HMSL) Itaim, Rede D' or, Brazil. Methods: This was a prospective, non-randomized study, conducted from February 2015 to November 2016. The institution' s preestablished protocol was followed when vascular access was requested. Indications, prevalent diseases, type of catheter implanted, technical success, and complications related to the catheters were analyzed and inclusion and exclusion criteria are described. Results: A total of 256 vascular accesses were requested, and 236 PICCs (92.1%) and 20 CICVCs (7.9%) were implanted. The main indications were as follows: prolonged antibiotic therapy (52%), PPN (19.3%), and difficult venous access (16%). Technical successes was achieved in 246 catheter placements (96.1%). The right basilic vein was the most common vein punctured for access, in 192 patients (75%), followed by the right brachial vein, in 28 patients (10.9%). Conclusions: Ultrasound-guided and fluoroscopy-positioned PICC placement had a low incidence of complications, reduced infection rates, and proved safe and effective in cases of difficult vascular access. PICCs can be considered the devices of choice for central vascular access.

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The Cobweb Sign: Percutaneous Silastic Long Line Tip Placement in Tributaries of Superficial Veins

Cited by 5 publications

References 6 publications

Malposition of peripherally inserted central catheter: Experience from 3,012 patients with cancer

Malposition of peripherally inserted central catheter: Experience from 3,012 patients with cancer

Malposition of peripherally inserted central catheter: Experience from 3012 cancer patients

Cateteres venosos centrais de inserção periférica: alternativa ou primeira escolha em acesso vascular?

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