| Percutaneous transfemoral repositioning of malpositioned central venous catheters. | |
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MedLine Citation:
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PMID: 7726009 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Central venous catheters inserted by blind surgical placement may not advance into a satisfactory position and may require repositioning. Malpositioning via surgical insertion is common in patients in whom central venous catheters have previously been placed, as these patients are more likely to have central venous thrombosis and distortion of central venous anatomy. This is less of a problem when catheter placement is guided by imaging; however, even when insertion is satisfactory, central venous catheters may become displaced spontaneously after insertion (Fig. 1). Repositioning can be effected by direct manipulation using guidewires or tip-deflecting wires [1, 2], by manipulation via a transfemoral venous approach [3-5], and by injection of contrast material or saline [6]. Limitations of the direct approach include (1) the number and type of maneuvers that can be performed to effect repositioning when anatomy is distorted, (2) difficulty in accessing the catheter, and (3) the risk of introducing infection. Moreover, these patients are often immunosuppressed, and there is a risk of introducing infection by exposing and directly manipulating the venous catheter. Vigorous injection of contrast material or saline may be unsuccessful for the same reasons: It seldom exerts sufficient force to reposition large-caliber central venous catheters and may cause vessel damage or rupture if injection is made into a small or thrombosed vessel. We illustrate several alternative methods for catheter repositioning via a transfemoral venous approach. |
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Authors:
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G G Hartnell; M Roizental |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 164 ISSN: 0361-803X ISO Abbreviation: AJR Am J Roentgenol Publication Date: 1995 Apr |
Date Detail:
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Created Date: 1995-05-19 Completed Date: 1995-05-19 Revised Date: 2008-02-15 |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1003-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiological Sciences, Deaconess Hospital, Boston, MA, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Catheterization, Central Venous / adverse effects, methods* Catheterization, Peripheral Female Humans Male Middle Aged Punctures Radiography, Interventional* Radiography, Thoracic |
| Comments/Corrections | |
Comment In:
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AJR Am J Roentgenol. 1996 Jun;166(6):1496
[PMID:
8633476
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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