The journal of vascular access
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Ultrasound-guided cannulation of the axillary vein in the infraclavicular area has several potential advantages for both short-term and long-term venous access devices. Currently, there are two techniques to approach axillary vein for ultrasound-guided cannulation: out-of-plane puncture in the short-axis view and the in-plane puncture in the long-axis view. We propose a novel ultrasound-guided puncture technique of axillary vein for centrally inserted central catheter placement, which consists in the oblique-axis view of the axillary vein coupled with the in-plane puncture. The main objectives of this study were feasibility and safety of this approach. The primary endpoints were the success rate and early complications; the secondary endpoints were late complications. ⋯ Our data show that the oblique axis-in-plane technique of the ultrasound approach to the axillary vein is feasible and safe.
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Catheter misplacement is a common complication during central vein catheterisation, and during subclavian vein catheterisation, one of the most common misplacements of the catheter is the ipsilateral internal jugular vein. Facing this type of misplacement, we tried to find an ultrasound-guided method to reposition the guidewire during subclavian vein catheterisation in adults.
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Observational Study
A modified approach for ultrasound-guided axillary venipuncture in the infraclavicular area: A retrospective observational study.
Catheterization of the axillary vein in the infraclavicular area has important advantages in patients with long-term, indwelling central venous catheters. The two most commonly used ultrasound-guided approaches for catheterization of the axillary vein include the long-axis/in-plane approach and the short-axis/out-of-plane approach, but there are certain drawbacks to both approaches. We have modified a new approach for axillary vein catheterization: the oblique-axis/in-plane approach. ⋯ The ultrasound-guided oblique-axis/in-plane approach is a safe and reliable alternative to the routine ultrasound-guided approach for axillary venous catheterization.
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Central venous catheters or "venous access devices" include totally implantable venous access devices or "ports," peripherally inserted central catheters, and tunneled lines. Venous access devices are now the standard of care in patients requiring long-term intravenous drug administration. Arm venous access device placement is a valuable option for vascular access yet often complicated or rendered practically impossible by the condition and size of peripheral veins. We describe a modification of the arm venous access device implantation technique that we use in our department in order to offer this option to our patients, regardless of their peripheral veins condition. ⋯ The "Arm-to-Chest Tunneling" method offers the alternative to place a venous access device in a more discreet site in the arm, even in cases in which arm veins are inadequate.