Ultrasound-Guidance Can Reduce Adverse Events During Femoral Central Venous Cannulation

Powell, John; Mink, Jennifer; Nomura, Jason T.; Levine, Brian J.; Jasani, Neil; Nichols, Wendy; Reed, James F.; Sierzenski, Paul

doi:10.1016/j.jemermed.2013.08.023

Cited by 28 publications

(25 citation statements)

References 13 publications

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“…Ultrasound guidance for CVC placement was not routinely used by all physicians, despite the proven superiority of ultrasound-guided CVC placement over the landmark technique [5][6][7][8][9]. We did not look into motives for the omission of ultrasound during insertion.…”

Section: Discussionmentioning

confidence: 99%

The practice of platelet transfusion prior to central venous catheterization in presence of coagulopathy: a national survey among clinicians

et al. 2017

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Section: Discussionmentioning

confidence: 99%

The practice of platelet transfusion prior to central venous catheterization in presence of coagulopathy: a national survey among clinicians

et al. 2017

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“…Small prospective trials using US guidance for femoral venous access have demonstrated improved safety and overall success rates in patients on hemodialysis . A prospective study evaluating the use of US guided femoral central venous cannulation in the emergency room among 143 patients compared 60 central venous cannulations (42%) under US guidance to 83 (58%) via landmark technique and found a trend toward a decrease in recorded adverse events (3.3% vs. 9.6%, P = 0.145) in the US arm . The largest study assessing the use of US guided access in patients undergoing catheter based EP procedures was published by Wynn et al .…”

Section: Discussionmentioning

confidence: 99%

“…17 A prospective study evaluating the use of US guided femoral central venous cannulation in the emergency room among 143 patients compared 60 central venous cannulations (42%) under US guidance to 83 (58%) via landmark technique and found a trend toward a decrease in recorded adverse events (3.3% vs. 9.6%, P = 0.145) in the US arm. 10 The largest study assessing the use of US guided access in patients undergoing catheter based EP procedures was published by Wynn et al 11 from the United Kingdom. They prospectively assessed patients undergoing AF ablation procedures and compared femoral venous access using a standard approach in 146 patients and using US guided access in 163 patients.…”

Section: Comparison With Other Data On Ultrasound Guided Vascular Accessmentioning

confidence: 99%

Vascular Complications During Catheter Ablation of Cardiac Arrhythmias: A Comparison Between Vascular Ultrasound Guided Access and Conventional Vascular Access

Sharma

Padala

Gunda

et al. 2016

Cardiovasc electrophysiol

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“…Access to the left common femoral vein was then achieved using real-time ultrasound guidance. 5 The patient's girth required a very long access system. An Accustick system (Boston Scientific, Natick, MA) was used.…”

Section: Methodsmentioning

confidence: 99%

Use of Noncontrast Computed Tomography of the Inferior Vena Cava for Real-Time Imaging Guidance for the Placement of Inferior Vena Cava Filters

et al. 2014

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Appropriate placement of an inferior vena cava (IVC) filter necessitates imaging of the renal veins and characterization of their number and their confluence with the IVC. Imaging is desirable during filter placement to ensure that when an IVC filter is deployed, its tip is at or below the inferior aspect of the confluence of the inferiormost renal vein with the IVC. Placement of an IVC filter above the renal veins can lead to thrombosis of the renal veins if an embolus is caught by the filter. Placement of the filter too far below the renal veins creates a dead space in the IVC above the IVC filter if an embolus is caught. A second thrombus can then form above the filter and subsequently embolize to the lungs. Classically, imaging during placement of IVC filters is with conventional inferior vena cavography and fluoroscopy. 2-4Keywords ► inferior vena cava ► computed tomography ► filterplacementguidance ► deep vein thrombosis ► obesity AbstractAppropriate placement of an inferior vena cava (IVC) filter necessitates imaging of the renal veins because when an IVC filter is deployed its tip should be at or below the inferior aspect of the inferiormost renal vein. Traditionally, imaging during placement of IVC filters has been with conventional cavography and fluoroscopy. Recently, intravascular ultrasound has been used for the same purpose but with additional expense. Morbidly obese patients often exceed the weight limit of fluoroscopy tables. In addition, short obese patients are at risk of falling from narrow fluoroscopy tables. For such patients, computed tomography (CT) guidance is a viable alternative to conventional fluoroscopic guidance. IVC placement was performed in the CT suite for two obese patients who exceeded the weight limits of the available fluoroscopy tables. In one case, a Vena-Tech filter (Braun Medical, Melsungen, Germany) was placed using CT fluoroscopy. In the second case, a Recovery (Bard, Murray Hill, NJ) filter was placed using intermittent limited z-axis scanning. In the first case, the filter was placed below the level of the renal veins and above the confluence of the iliac veins, which is acceptable placement. In the second case, with refinement of technique, the filter tip was placed less than 1 cm below the inferiormost renal vein, which is considered optimal placement. CT of the IVC precisely images the renal veins and can characterize their number and their confluence with the IVC. CT guidance is a viable alternative to fluoroscopic guidance for the placement of IVC filters in morbidly obese patients.

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Ultrasound-Guidance Can Reduce Adverse Events During Femoral Central Venous Cannulation

Cited by 28 publications

References 13 publications

The practice of platelet transfusion prior to central venous catheterization in presence of coagulopathy: a national survey among clinicians

The practice of platelet transfusion prior to central venous catheterization in presence of coagulopathy: a national survey among clinicians

Vascular Complications During Catheter Ablation of Cardiac Arrhythmias: A Comparison Between Vascular Ultrasound Guided Access and Conventional Vascular Access

Use of Noncontrast Computed Tomography of the Inferior Vena Cava for Real-Time Imaging Guidance for the Placement of Inferior Vena Cava Filters

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