Endovascular intervention for central venous cannulation in patients with vascular occlusion after previous catheterization
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Endovascular intervention for central venous cannulation in patients with vascular occlusion after previous catheterization. / Pikwer, Andreas; Acosta, Stefan; Kölbel, Tilo; Åkeson, Jonas.
In: J VASC ACCESS, Vol. 11, No. 4, 19.10.2010, p. 323-328.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Endovascular intervention for central venous cannulation in patients with vascular occlusion after previous catheterization
AU - Pikwer, Andreas
AU - Acosta, Stefan
AU - Kölbel, Tilo
AU - Åkeson, Jonas
PY - 2010/10/19
Y1 - 2010/10/19
N2 - OBJECTIVES: This study was designed to assess endovascular intervention for central venous cannulation in patients with vascular occlusion after previous catheterization.METHODS: Patients referred for endovascular management of central venous occlusion during a 42-month period were identified from a regional endovascular database, providing prospective information on techniques and clinical outcome. Corresponding patient records, angiograms, and radiographic reports were analyzed retrospectively.RESULTS: Sixteen patients aged 48 years (range 0.5-76), including 11 females, were included. All patients but 1 had had multiple central venous catheters with a median total indwelling time of 37 months. Eleven patients cannulated for hemodialysis had had significantly fewer individual catheters inserted compared with 5 patients cannulated for nutritional support (mean 3.6 vs. 10.2, p<0.001) before endovascular intervention. Preoperative imaging by magnetic resonance tomography (MRT) in 8 patients, computed tomography (CT) venography in 3, conventional angiography in 6, and/or ultrasonography in 8, verified 15 brachiocephalic, 13 internal jugular, 3 superior caval, and/or 3 subclavian venous occlusions. Patients were subjected to recanalization (n=2), recanalization and percutaneous transluminal angioplasty (n=5), or stenting for vena cava superior syndrome (n=1) prior to catheter insertion. The remaining 8 patients were cannulated by avoiding the occluded route.CONCLUSIONS: Central venous occlusion occurs particularly in patients under hemodialysis and with a history of multiple central venous catheterizations with large-diameter catheters and/or long total indwelling time periods. Patients with central venous occlusion verified by CT or MRT venography and need for central venous access should be referred for endovascular intervention.
AB - OBJECTIVES: This study was designed to assess endovascular intervention for central venous cannulation in patients with vascular occlusion after previous catheterization.METHODS: Patients referred for endovascular management of central venous occlusion during a 42-month period were identified from a regional endovascular database, providing prospective information on techniques and clinical outcome. Corresponding patient records, angiograms, and radiographic reports were analyzed retrospectively.RESULTS: Sixteen patients aged 48 years (range 0.5-76), including 11 females, were included. All patients but 1 had had multiple central venous catheters with a median total indwelling time of 37 months. Eleven patients cannulated for hemodialysis had had significantly fewer individual catheters inserted compared with 5 patients cannulated for nutritional support (mean 3.6 vs. 10.2, p<0.001) before endovascular intervention. Preoperative imaging by magnetic resonance tomography (MRT) in 8 patients, computed tomography (CT) venography in 3, conventional angiography in 6, and/or ultrasonography in 8, verified 15 brachiocephalic, 13 internal jugular, 3 superior caval, and/or 3 subclavian venous occlusions. Patients were subjected to recanalization (n=2), recanalization and percutaneous transluminal angioplasty (n=5), or stenting for vena cava superior syndrome (n=1) prior to catheter insertion. The remaining 8 patients were cannulated by avoiding the occluded route.CONCLUSIONS: Central venous occlusion occurs particularly in patients under hemodialysis and with a history of multiple central venous catheterizations with large-diameter catheters and/or long total indwelling time periods. Patients with central venous occlusion verified by CT or MRT venography and need for central venous access should be referred for endovascular intervention.
KW - Adolescent
KW - Adult
KW - Aged
KW - Catheterization, Central Venous/adverse effects
KW - Child
KW - Child, Preschool
KW - Constriction, Pathologic
KW - Endovascular Procedures
KW - Female
KW - Humans
KW - Infant
KW - Magnetic Resonance Angiography
KW - Male
KW - Middle Aged
KW - Nutritional Support
KW - Phlebography/methods
KW - Renal Dialysis
KW - Retrospective Studies
KW - Risk Assessment
KW - Risk Factors
KW - Sweden
KW - Time Factors
KW - Tomography, X-Ray Computed
KW - Treatment Outcome
KW - Vascular Diseases/diagnosis
KW - Vascular Patency
KW - Veins/physiopathology
KW - Young Adult
U2 - 10.5301/jva.2010.5813
DO - 10.5301/jva.2010.5813
M3 - SCORING: Journal article
C2 - 20954129
VL - 11
SP - 323
EP - 328
JO - J VASC ACCESS
JF - J VASC ACCESS
SN - 1129-7298
IS - 4
ER -
