Document Detail

The cobweb sign: percutaneous silastic long line tip placement in tributaries of superficial veins.
MedLine Citation:
PMID:  16193077     Owner:  NLM     Status:  MEDLINE    
We report a method for preventing misplacement of percutaneous silastic catheters in superficial vein tributary or venous plexus. Catheters inserted less than the length calculated by surface anatomy measurement due to resistance were studied in three patients. Contrast X-rays (Omnipaque, Nycomed Imaging AS, Oslo, Norway) of the catheters was performed to confirm the catheter tip placement position. On initial assessment, the catheter tip placement was thought to be satisfactory and infusion of TPN commenced. Following signs of extravasation, re-examination of the contrast X-rays demonstrated that multiple thin rays of omnipaque could be traced in different directions like a cobweb. In the third infant, we recognised the "cobweb" sign and prospectively withdrew the catheter tip 2 cm. Repeat contrast X-ray confirmed that the catheter tip was in a major superficial vein, infusion continued without further complication. We conclude that when the "cobweb" sign is noticed then the catheter should be removed or withdrawn 2 to 3 cm and repeat contrast X-ray performed..
Narendra Aladangady; Rahul Roy; Kate L Costeloe
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  25     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-29     Completed Date:  2006-01-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  671-3     Citation Subset:  IM    
Barts and the London Queen Mary's School of Medicine and Dentistry/Homerton University Hospital, Homerton Row, London, UK.
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MeSH Terms
Catheterization, Central Venous / adverse effects,  methods*
Extravasation of Diagnostic and Therapeutic Materials / radiography*
Infant, Newborn
Parenteral Nutrition, Total
Saphenous Vein
Vena Cava, Inferior / radiography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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