The journal of vascular access
-
Portacaths are tunnelled and totally implanted central venous access port devices (CVAPD). They are commonly used for intravenous antibiotic delivery in patients with cystic fibrosis. ⋯ It is therefore important to be aware of portacath associated complications and their imaging features. This pictorial review illustrates and discusses common complications associated with Portacath devices.
-
Some hemodialysed patients need definitive central venous catheterization. One of the main complications is catheter infection, and each infection must be treated. We report a case of an unusual cause of central venous catheter (CVC) infection: physical examination and catheter opacification demonstrated two pin-holes in the catheter. It was possible to salvage the catheter following a treatment regimen combining systemic antibiotics, antibiotic locks, fibrinolytics, and removal of a catheter segment.
-
Comparative Study
The effect of laterality on venous thromboembolism formation after peripherally inserted central catheter placement.
The use of peripherally inserted central venous catheters (PICCs) has become widespread in hospital medicine. PICCs are preferentially placed on the right side due to anatomic ease of insertion into the superior vena cava. However, no data exists examining whether this practice is also protective against symptomatic venous thrombosis. The purpose of this study is to assess placement of right-sided versus left-sided PICCs and the resulting rates of venous thromboembolism (VTE) in a community teaching hospital. ⋯ Laterality of PICC placement is not significantly associated with symptomatic VTE formation. The overall rate of thrombosis in our study is comparable to that of previous studies.
-
Management of failing tunneled hemodialysis catheters, sometimes the only vascular access for hemodialysis, presents a difficult problem. In spite of various techniques having been developed, no consensus has been reached about the preferred technique, associated with the longest catheter patency. ⋯ The described procedure allowed maintenance of vascular access in our patient. Additionally, dilatation of the concomitant central vein stenosis opens an option for another attempt for arteriovenous fistula creation.
-
Percutaneous transhepatic catheters are a form of nonconventional access for patients requiring hemodialysis. We report a complication of these catheters which has not been previously described in the literature. The mechanism for intrapleural migration and a way to avoid this potential complication are discussed.